This service is rated as Good overall.
The key questions are rated as:
Are services safe? – Requires Improvement
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 St Mary’s Urgent Care Centre (now named St Mary’s Urgent Treatment Centre) on 13 July 2017. The overall rating was inadequate, and the provider was placed in special measures for a period of six months. In addition, we took enforcement action in the form of a warning notice in respect of good governance.
We carried out an announced focused follow-up inspection on 22 August 2017 to check that the necessary improvements had been made in respect of the warning notice, or whether further enforcement action was required. At the inspection we found improvements had been made to prevent further enforcement action.
We carried out an announced comprehensive inspection on 27 March 2018 to follow-up on the comprehensive inspection undertaken on 13 July 2017. We found the provider had made considerable improvements and was taken out of special measures. However, we found some areas of non-compliance in respect of good governance and the provider was rated requires improvement overall.
The comprehensive report for the July 2017 inspection, the focused follow-up inspection in August 2017 and the report of March 2018 can be found by selecting the ‘all reports’ link for St Mary’s Urgent Treatment Centre (UTC) on our website at www.cqc.org.uk.
This inspection, carried out on 5 June 2019, was an announced comprehensive inspection to review in detail the actions taken by the provider since our March 2018 inspection to improve the quality of care and to confirm that the provider was now meeting legal requirements.
At this inspection we found:
- The provider had addressed the findings of our previous inspection and was able to demonstrate improvement in performance and resilience in relation to substantive staffing and performance against national targets.
- Although the service had systems in place to manage risk so that safety incidents were less likely to happen they had failed to facilitate formal training to non-clinical reception staff at the point of entry to the service in A&E and the UTC to assure themselves that staff could adequately recognise emergency symptoms.
- There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns. All staff had been trained to a level appropriate to their role.
- There was an open and transparent approach to safety and systems were in place for recording, reporting and sharing learning from significant events.
- The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
- There was a programme of quality improvement including clinical audit which had a positive impact on quality of care and outcomes for patients.
- Staff had the skills, knowledge and experience to deliver effective care.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- The service took complaints and concerns seriously to improve the quality of care. However, some response times to complainants were outside national guidance.
- Leaders demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
- The provider engaged with patients and staff to improve the service.
- The provider was aware of the duty of candour and examples we reviewed showed the service complied with these requirements.
- There was a focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients.
The areas where the provider should make improvements are:
- Review the frequency of basic life support training for non-clinical staff in line with guidance.
- Continue to monitor waiting times and delays following triage to the UTC to capture any theme or trend to better improve the patient experience.
- Continue to review and monitor the governance oversight of the complaints response process to ensure these are managed within the appropriate timeframes.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care