We carried out an announced comprehensive inspection at DCCS at Buckden and Little Paxton Surgeries as part of our inspection programme.

Dermatology Clinic Community Service LTD is an independent provider of a dermatology assessment, a minor surgery service, a vasectomy service, and a lymphedoema clinic. The service holds contracts with the local Clinical Commissioning Group (CCG) to deliver community services, closer to patient’s homes and avoid attendances at secondary care. They have been providing these services for approximately 16 years. They treat between 2,000 and 2,500 patients each year.

Dermatology Clinic Community Service LTD is registered with the Care Quality Commission to provide services at Buckden and Little Paxton Surgeries (a GP practice) with locations at Little Paxton (a branch site of Buckden and Little Paxton Surgeries), Warboys, St Ives in Huntingdon and in Hinchingbrook Hospital Treatment Centre. The services offered are dermatology outpatient opinions, minor surgery including biopsies, vasectomy, cryotherapy and lymphoedema.

The lead GP is the 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.

The service proactively gained feedback from patients with regular reports compiled from the surveys conducted at each clinic. As part of our inspection we reviewed the results of the patient surveys that had been collected over the previous 12 months.

We received 36 Care Quality Commission comment cards, and all of these were wholly positive about the care and service and positive outcomes the patients had received. We spoke with five patients who reported that they had received excellent care in a timely and efficient manner and by staff who were caring and dedicated.

Our key findings were

:

• We saw there was strong leadership within the service and the team worked together in a cohesive, supported, and open manner. Since our previous inspection there had been changes to the management team and a new manager started in December 2018.
• There was an effective system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• All staff had received a Disclosure and Barring Service (DBS) check.
• Risks to patients were assessed and the service provided evidence that further improvements to these systems were in progress.
• The service held a comprehensive central register of policies and procedures which were in place to govern activity; staff were able to access these policies easily and all staff had signed each one. This ensured that the provider had oversight to manage the performance of the staff.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• All patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• The service proactively sought feedback from staff and patients, which it acted on. Regular surveys were undertaken and reports collated from the findings and action taken where required.

The areas where the provider should make improvements are:

• Continue to embed the newly implemented systems and processes to ensure they are effective, including those relating to the management of training, safety alerts, health and safety and infection prevention and control.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 6 April 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive, and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring care in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Dermatology Clinic Community Service LTD is an independent provider of a dermatology assessment, a minor surgery service, a vasectomy service, and a Lymphoedema clinic. The service holds contracts with the local Clinical Commissioning Group (CCG) to deliver community services, closer to patient’s homes and avoid attendances at secondary care. They have been providing these services for approximately 15 years. They treat between 2,000 and 2,500 patients each year.

Dermatology Clinic Community Service LTD is registered with the Care Quality Commission to provide services at Buckden and Little Paxton Surgeries (a GP practice) with locations at Little Paxton (a branch site of Buckden and Little Paxton Surgeries), Warboys, and St Ives in Huntingdon and in Hinchingbrook Hospital Treatment Centre. The services offered are dermatology outpatient opinions, minor surgery including biopsies, vasectomy and cryotherapy and .Lymphoedema

The lead GP is the 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.

The service proactively gained feedback from patients with regular reports compiled from the surveys conducted at each clinic. As part of our inspection we reviewed the results of the patient surveys that had been collected over the previous 12 months. The service undertook these surveys in the individual clinics where patients and members of the public shared their views and experiences of the service.

We received 41 Care Quality Commission comment cards, and all of these were wholly positive about the care and service and positive outcomes the patient had received. We spoke with three patients who reported that they had received excellent care in a timely and efficient manner and by staff who were caring and dedicated.

Our key findings were:

• We saw there was strong leadership within the service and the team worked together in a cohesive, supported, and open manner.
• There was an effective system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand. Although none had been received, we were assured there were systems and processes in place to ensure that complaints would be fully investigated and patients responded to with an apology and full explanation.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• All staff had received a Disclosure and Barring Service (DBS) check.
• Risks to patients were assessed and well managed. We found that the provider had clear oversight of all locations from which they provided their services.
• The service held a comprehensive central register of policies and procedures which were in place to govern activity; staff were able to access these policies easily and all staff had signed each one. This ensured that the provider had oversight to manage the performance of the staff.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• All patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• The service proactively sought feedback from staff and patients, which it acted on. Regular surveys were undertaken and reports collated from the findings and action taken where required.
• We noted some medicines were not in a locked cupboard and at times the room was left unoccupied and unlocked. The management team took immediate action following the inspection and was arranging for key pads to be fitted to the rooms.

The area where the provider should make improvements is

• Review and improve the arrangements for the safe storage of medicines

We talked with three people who had recently used the service and they confirmed that before any treatment had been carried out it had been fully explained and that they had been asked for their consent.

The records showed that people had received the treatment they required. Records were written in detail and provided a clear record of consultations and what treatments people had received.

Appropriate actions had been taken to make sure that people were safe from infection or to resolve infection prevention and control issues when they were identified.

Systems were in place to regularly check and monitor the way the service was run.