This inspection took place on the 26 October 2016 and was unannounced.

The Assessment & Treatment Service provides specialist medical and therapy support to other David Lewis locations, primarily on the campus located at Warford in Cheshire.

Services include 24 hour nursing cover and a minor injuries clinic as well as a variety of other services such as diagnostics, neurology, occupational therapy and dietetics.

The last inspection took place on the 15 January 2014 and we found at that time that all the legal requirements were met.

The service has a registered manager. A registered manager is a person who has 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.

During this inspection we found that the service was well organised and managed, ensuring that robust arrangements were in place to provide medical and nursing cover for the people living on the David Lewis campus.

Risks to people using the service were regularly reported on and analysed. Where risks had been identified the service had been proactive in looking at potential causes and putting measures in place to try to reduce them.

There were clear and detailed policies for the administration of medicines, which enabled to staff to work autonomously to some degree for the benefit of people using the service.

Training was seen as being of extreme importance and all the staff we spoke with told us that opportunities for training and further development were excellent.

Staff were very aware of the need to gain consent from people using the service, prior to any treatment being given. They demonstrated thought and compassion in describing how they achieved this.

Records of all the care and medical interventions people received were held electronically and there were good systems in place for updating them and ensuring they were accurate.

The registered provider had a number of systems in place to ensure the quality of the service.

During our unannounced inspection on 15 January 2014 we spoke to the Director of Clinical Services, the Human Resources Manager, a human resources advisor, a general practitioner, three members of staff, three people who used the service and one of their carers.

One carer we spoke to said; “The staff here always treat people with dignity and respect, I have never had any concerns whatsoever.”

We saw that staff interacted well with people who used the service and were kind and caring in the way that they delivered care to them.

We were able to confirm that the provider had a recruitment process in place which complied with employment legislation and the Human Rights Act.

The staff we spoke to told us that there was effective team work in place. One newly appointed nurse told us; “I feel very well supported and can ask questions freely. I am enjoying working here.”

The provider had systems in place for the review and destruction of documentation in line with the Data Protection Act.

When we carried out our visit to the Assessment and Treatment service of David Lewis we visited the clinic and spoke to three people and two relatives.

All were complimentary about the service they received and no-one expressed any concerns. One relative told us they had been provided with “the best service you could hope for”.

We looked at the means by which the service obtained consent for treatment and saw that their processes were well suited to the needs of the people for whom they provided care. Mental capacity assessments and best interest decisions were detailed and well documented.

We examined the arrangements for providing 24 emergency care and saw that they were provided by appropriately skilled staff and were well organised. Other health professionals from outside of David Lewis were complimentary about the quality of the service provided.

Appropriate arrangements were in place for the maintenance of medical equipment. The equipment was appropriate an available in sufficient quantities.

There were complaints processes in place that were tailored to the needs of the people who used the service and although no complaints were on record we were assured that any complaint would be handled correctly.

When we visited we spoke to two people who were waiting to see GPs or other health professionals in the clinic. One person told us that he felt treated well at the clinic and that staff were polite and kind.

We asked one of the people visiting the clinic about their health action plan and they were able to talk to us about it. They told us they were satisfied with the medical services provided.

One person told us that they felt safe at David Lewis and would feel confident to complain. The other person was able to respond positively when asked whether they felt safe.