24 January 2019
During a routine inspection
This service is rated as Good overall. (Previous inspection January 2018– Requires Improvement).
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, follow up inspection at North Central London (NCL) South Hub on 22 and 24 January 2019. CQC previously inspected the service on 23 and 25 January 2018 and asked the provider to make improvements because although the care being provided was effective, caring and responsive, it was not being provided in accordance with the relevant regulations relating to safe and well led care.
At our previous inspection we found the provider had breached Regulation 12 (1) (Safe care and treatment) and Regulation 17 (1) (Good governance) of the Health and Social Care Act 2008. This was because staff checks were not being undertaken to the appropriate level and because the provider’s decision not to carry oxygen in home visit vehicles had not been sufficiently risk assessed. We also noted the absence of appropriate systems for sharing learning from significant events and for ensuring safety alerts improved patient safety.
The service wrote to us to tell us what they would do to make improvements and we undertook this comprehensive inspection to check the service had followed their plan and to confirm they had met the legal requirements.
At this inspection we found:
•Action had been taken since our last inspection in January 2018, such that when safety incidents happened, systems were in place to ensure learning was shared and processes improved.
•Action had been taken since our last inspection, such that Disclosure and Barring Service (DBS) checks for home visit drivers were now being undertaken to the level stipulated in the provider’s Recruitment Policy. DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable.
•The service ensured care and treatment was delivered according to evidence-based guidelines.
•Staff involved and treated people with compassion, kindness, dignity and respect.
•There was a strong focus on continuous learning and improvement at all levels of the organisation.
•The leadership, governance and culture of the service promoted the delivery of high-quality person-centred care.
The areas where the provider should make improvements are:
•Continue to carry out medicines audits to ensure prescribing patterns are in line with best practice guidelines for safe prescribing.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care