Archived: Blossoms Healthcare LLP- Tooley Street

Updated 4 July 2019

Blossoms Healthcare LLP Tooley street is located at 3rd Floor, 139 Tooley Street, London, SE1 2RT which is an office space. The service rents the third floor of the building which is a listed building. The service treats between 200 and 500 patients per month. We were informed that between April 2018 and April 2019 this location provided 2518 GP appointments and 1909 health screens. The service predominantly provides services to the staff of four large corporate organisations. The service told us that over 90% of their custom comes from these clients with under 10% from private individuals. The service did not consult with children.

The service delivers GP services, health assessments and occupational health advice. Patients can be referred to other services for diagnostic imaging and specialist care. The service team included four private doctors; two healthcare assistants; three receptionists and a medical secretary.

The provider is registered with the Care Quality Commission (CQC) for the regulated activities of Treatment of Disease Disorder or Injury, and Diagnostic & Screening Procedures.

We carried out this inspection on 16 May 2019. The inspection was led by a CQC inspector and a GP specialist advisor.

Before visiting, we looked at a range of information that we hold about the service. We reviewed the last inspection report from 27 April 2018 and information submitted by the service in response to our provider information request. During our visit we interviewed staff (two private doctors; a chief nursing officer, the head of human resources and a non-clinical staff member and reviewed documents.

The provider is part of a larger organisation, HCA Healthcare Limited.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

Updated 4 July 2019

This service is rated as Good overall. (Previous inspection February 2018, prior to ratings programme)

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 Blossoms Healthcare Tooley Street on 16 May 2019 as part of our inspection programme.

The provider supplies private general practitioner services predominantly to staff working at four large corporate organisations. The provider also provides services to private fee-paying patients.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Blossoms Healthcare Tooley Street approximately 90% of patients are treated under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, we were only able to rate the services which are not arranged for patients by their employers. However, some of the evidence quoted in the report regarding the quality of fee-paying patient outside of this exemption stems from evidence of care provided to exempt patients as this was used to demonstrate the general quality of care provided to all patients using the service.

The provider is in the process of registering a new registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 23 CQC comments cards. All comment cards were positive with patients referring to the high standard of care provided by knowledgeable and supportive staff.

Our key findings were:

• The provider had systems in place to keep people safe and to review, act and learn from significant events. We reviewed examples where the provider had made contact with the patient’s NHS GP to pass on information that was clinically necessary with the patient’s consent. We were told that, when necessary to ensure patient safety, the service would contact the patients NHS GP without consent. However records reviewed showed that the provider did not consistently keep records of patient’s NHS GP details. The provider told us after our inspection that it was now mandatory for new patients to provide the details of their NHS General Practitioner and that all existing patients who had not provided this information previously would be asked to provide it when they attend their next appointment.
• There were processes in place to effectively handle emergencies and risks were managed appropriately. Most appropriate recruitment checks had been completed for the staff whose files we reviewed. However, references had not been taken or retained for one healthcare assistant.
• Systems were in place for the safe management of medicines and we saw that the provider had processes in place to review prescribing. However, the provider was not undertaking regular reviews of antibiotic prescribing.
• Staff at the service assessed patients in accordance with best practice and current guidelines and had systems in place to monitor and improve the quality of care provided to patients.
• There was evidence of effective joint working and sufficient staffing to meet the needs of their patient population.
• Feedback indicated that patients were treated with dignity and care and the service had systems to support patients to be involved with decision about their care and treatment.
• The service met the needs of their targeted patient demographic and there were systems in place for acting on feedback and complaints.
• The service had adequate leadership and governance in place.
• There was clear strategy and vision which was tailored to patient need and staff and patients were able to engage and feedback to the service provider.

The areas where the provider should make improvements are:

• Obtain and retain references for all staff recruited
• Implement policies around obtaining patient’s NHS GP details prior to consultation.
• Review antibiotic prescribing to assess the extent to which the service is following best practice and guidance.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care