Archived: The Practice Group Complex Care

The Practice Group Complex Care is operated by The Practice Services Limited. The service provides complex care (this includes care such as; tracheostomy care, ventilation support and bowel and bladder management) to babies, children, young people and adults in their own homes.

We inspected this service using our focussed inspection methodology. This was in response to some information we had received from an external source that alleged poor staffing levels, poor record keeping and safety concerns.

We carried out the announced part of the inspection on 10 May 2019, along with phone calls to a sample of people who used the service and staff on 13 and 14 May 2019.

We announced the inspection the day before we visited to ensure we could access the office and speak with people who used the service and staff.

To get to the heart of patients’ experiences of care and treatment, we usually ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate. As this was a focussed inspection, we only looked at the safe question in response to alleged safety concerns.

At the time of the inspection 23 people used the service, the main service provided by this provider was community health services for adults as 18 people who used the service were aged 18 and over. Due to the focussed nature of the inspection, we chose to only inspect under our community health services for adults service framework.

Services we rate

We did not rate this location with an overall rating as we only looked at the safe key question. We rated safe as ‘good’ for community health services for adults because:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

• The service controlled infection risk well. Staff kept themselves, equipment and the premises visibly clean. They used control measures to prevent the spread of infection.

• The service had suitable premises and equipment and looked after them well.

• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

• Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

• The service followed best practice when managing medicines. Patients received the right medication at the right dose at the right time.

• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.

• The service did not always use safety tools to monitor safety and risk. However, safety information was collected and used to improve the service.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Achieson

Deputy Chief Inspector of Hospitals