Sciensus Pharma Services Limited

Updated 29 October 2021

Healthcare at Home was established in 1992 and is operated by Healthcare at Home Limited. The service provides clinical homecare and the supply of essential medicines to approximately 206,000 patients throughout the United Kingdom. Patients’ medicines and care are funded by either the NHS, pharmaceutical companies or privately, and are dependent on a referral from a GP, hospital consultant or private health insurer.

Clinical homecare describes care and treatment that takes place in a person’s own home, including nurse administration of medicines. It minimises the need for patients to attend hospital as either an inpatient or outpatient and helps support early discharge from hospital for patients with complex care needs. Healthcare at Home also provides a supply and delivery service to patients who administer their own medicines at home, delivering approximately 110,000 prescriptions each month. Medicines supplied are for patients with a variety of conditions including; chronic diseases, cancer care, HIV medicines, medicines for haemophilia patients and rheumatoid arthritis.

In July 2021, Healthcare at Home Ltd rebranded to be called Sciensus. However, at the time of our inspection the service continued to be registered as Healthcare at Home Ltd.

Healthcare at Home is registered to provide the following regulated activities:

• Treatment disease disorder and injury.
• Transport services, triage and medical advice provided remotely.
• Management of supply of blood and blood derived products.
• Diagnostic and screening procedures.
• Nursing care.

The provider has a nominated individual and ten registered managers.

What people who use the service say

We spoke with eight people in receipt of a service from Healthcare at Home. Five people told us staff had provided information about how to raise a concern or complaint and the others believed they could easily find that information on the provider’s website. All those we spoke with felt they could confidently raise a complaint, and without fear of a negative impact to the service they received. All spoke positively about the service provided by Healthcare at Home, reporting good or excellent service.

Updated 29 October 2021

Healthcare at Home was established in 1992 and is operated by Healthcare at Home Limited. The service provides clinical homecare and the supply of essential medicines to patients throughout the UK. Patients’ medicines and care funded by either the NHS, pharmaceutical companies or privately, and are dependent on a referral from a GP, hospital consultant or private health insurer.

Between 26 November and 14 December 2020, we carried out an unannounced, focused inspection of Healthcare at Home. The inspection was carried out in response to concerns raised about patients not receiving their prescribed medicines deliveries on time and being unable to contact the provider. Due to the seriousness of the concerns identified during the inspection, we suspended Healthcare at Home’s rating and issued a Notice of Decision to urgently impose conditions on the provider’s registration.

The conditions required the provider to:

• Ensure all service users who have had a failed delivery of any kind from 1 October 2020 to be reviewed by a suitably qualified professional to ensure that service users have not come to any level of harm.
• Devise and implement a system to ensure that backlogs of medicine deliveries were effectively mitigated against.
• Provide an action plan to the CQC outlining how the registered person intends to make improvements to the areas identified in the Notice of Decision.
• Provide a fortnightly report to the CQC which includes an analysis of audits undertaken to monitor completion and/or implementation of the systems set out in the above conditions.

The inspection rated Healthcare at Home inadequate and placed it into special measures. We told the provider it must take action to bring services into line with four legal requirements, Regulations 12, 16, 17 and 18 Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.

You can read our findings from our all of our previous inspections by selecting the ‘all reports’ link for Healthcare at Home on our website at www.cqc.org.uk.

This inspection was unannounced and focused to see what improvements the provider had made. We looked at the safe, responsive and well-led domains and focused on the concerns we raised to the provider following our previous inspection.

Our rating of this service improved. We no longer rated one or more key questions as inadequate and have removed it from special measures.

We rated the service as good overall because:

• The providers governance processes now operated effectively throughout the service. The provider had developed, implemented and monitored a service recovery action plan that demonstrated improvement.
• The provider had learned lessons from the implementation of a new information technology system in October 2020. The provider continued to develop its information technology systems for patients and staff, but with greater oversight and structures to manage risks.
• The provider ensured all patients who had a failed medicine delivery, and did not receive the care they should, were reviewed by a suitably qualified clinical professional to ensure they had not come to any level of harm. Where harm was identified, the provider took immediate actions to refer the patient to back their identified responsible clinician for further review.
• The provider had improved performance to respond to and investigate complaints in a timely manner. Staff used concerns and complaints as an opportunity to learn and drive improvement.
• The provider had devised and implemented a system to ensure medicine deliveries were well managed to prevent backlogs. We saw improvement in the number of successful medicine deliveries made to patients on the day.
• The provider now ensured there was enough staff across all its services to ensure patients’ needs are met. This included nurses, call handlers and dispensary staff. Managers regularly reviewed and adjusted staffing levels and skill mix and gave temporary staff a full induction.
• The provider had taken action to ensure the leadership and culture of the service encouraged staff and patients to raise concerns without fear of retribution. Staff and patients, we spoke with knew how to speak up or raise a concern and felt confident to do so.

However:

• The provider did not thoroughly investigate all incidents reported in the service. We remained concerned that incidents or near misses identified as resulting in no patient harm were not fully investigated.
• Although the provider monitored the practice of staff to check and record patient’s allergy status immediately prior to every medicine administration. We continued to see the location of patient allergy information and staff’s recording of allergy checks varied between the patient records we looked at.
• It remained difficult to identify vulnerable patients on the providers electronic record. This information was not immediately highlighted to staff accessing the patient’s electronic record.

Updated 29 October 2021

The main service provided by this provider was community healthcare services for adults. Our findings also apply to the core service community healthcare services for children, young people and families, as such we do not repeat the information but cross-refer.