10, 11, 12 October 2022
During a routine inspection
We last inspected this service in November and December 2021. Following this inspection, we took enforcement action against the provider due to the concerns we identified during the inspection. We issued the provider with 2 warning notices for breaches of regulation 17 and regulation 18 of the Health and Social Care Act 2014. The service was subsequently rated as inadequate and was placed into special measures by the Chief Inspector of Hospitals.
At this inspection in October 2022, we found that the service had made significant improvements.
Our rating of this location improved. We rated it as good because:
- The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service-controlled infection risk well on home visits. Staff assessed risks to patients, acted on them and kept good care records. Nursing staff worked within their working hours to deliver effective care at home including good Personal Protective Equipment and hand hygiene. The patient services department responded promptly to calls, the performance on the number of calls answered had improved with an average call wait time of 5 minutes. The patient support programme coordinators supported patients to administer specialist medicines safely at home
- Managers ensured that staff completed all mandatory and specialist training relevant to their roles, and had regular team meetings, supervision and appraisals. Patient facing staff completed safeguarding training. Nurses referred safeguarding incidents to the Local authority via an NHS safeguarding application on their smartphones. Managers made sure staff were competent. Incidents at home and safeguarding incidents were well reported and escalated. Outcomes of incidents were shared with commissioners such as the NHS trust, and lessons learned were shared through ‘head of nursing town hall meetings’.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions.
- Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff reported the warehouse safety hazards via smart survey scan and actioned by senior leadership team. The service had a robust governance process and monitored its performance and risks regularly. The corporate and clinical risk registers included relevant risks and were monitored and managed effectively.
However:
- The patient’s satisfaction survey was last done in 2020.This meant that the service had not captured recent views from patients.
The service had closed other registered locations in 2022 and brought all activities to the registered location in Harlow, Essex. However, there remained in Surrey, a Mobile unit, infusion centre and the healthcare centre. There was also the Patient support programme in Derby.
This report describes our judgement of the quality of care by the provider from this location. It is based on a combination of what we found when we inspected and a review of all information available to the Care Quality Commission including information given to us from patients, the public and other organisations. For this inspection, we looked at the 5 domains of safe, effective, caring, responsive and well led, and have applied ratings to each domain and an overall rating.