6 March 2018
During a routine inspection
This service is rated as Good overall. (Previous inspection September 2014 – No concerns)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Arrowe Park Hospital GP Out of Hours Service on 6 March 2018 as part of our inspection programme and in conjunction with the inspection carried out for Wirral Community NHS Foundation Trust.
At this inspection we found:
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The provider had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
- There were systems in place to mitigate safety risks, including those associated with health and safety, infection control and dealing with safeguarding.
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The provider routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
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Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
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We saw that staff treated patients with compassion, kindness, dignity and respect.
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The service was underperforming in their targets for indicators relating to access and response time. However, patient feedback was positive in respect of them being able to access care and treatment from the service within appropriate timescales for their needs.
- The service facilities were accessible and well equipped to treat patients and meet their needs. The vehicles used for home visits were maintained and well equipped, however not all required checks on the vehicles were carried out on a daily basis.
- There were systems in place that enabled staff to access patient records and out of hours staff provided other services, such as the patient’s own GP and hospital, with the information they needed following contact.
- There was a clear leadership structure and staff felt supported by leaders and management. The provider sought patient views about improvements that could be made to the service; including through the Friends and Family Test, internal surveys and share your experience information. It acted, where possible, on feedback.
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Staff worked well together as a team and all felt supported to carry out their roles.
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There was a focus on continuous learning and improvement at all levels of the organisation.
- The provider was aware of the requirements of the duty of candour.
The areas where the provider should make improvements are:
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Review the maintenance programme for the out of hours premises at Arrowe Park Hospitalto ensure an environment is maintained that enables good cleaning and infection, prevention and control measures. In particular the reception carpet and waiting room walls.
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Review protocols for the out of hours vehicles to ensure sharps bins carried in the vehicles are maintained safely and not overfilled and that daily safety and hygiene checks are carried out.
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Review the recruitment policy to include obtaining photographic identification being obtained prior to employment.
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Continue to review the staffing structure and model of care in order to improve access in a timely manner.
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Review audit planning to include a programme of audits that are based on local, national and service priorities.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice