We carried out an announced comprehensive inspection at Head Quarters on 26 January 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 services 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.

Head Quarters (known as Here) provides a memory assessment service and musculoskeletal service to outpatients from the Brighton and Hove area. The organisation is part of Here, which also operates a primary care referral service, a local GP practice, a community eye service and a wellbeing service. This report relates only to the services registered as Head Quarters which are the memory assessment service and the musculoskeletal service. Services are based across various branch sites within the Brighton and Hove area.

Dr Helen Curr and Mr Jon Ota are the registered managers. 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.

Twenty seven people provided feedback about the service via comment cards all of which were very positive about the standard of care they received. The service was described as excellent, professional, helpful and caring. Patients said they felt listened to and found the staff to be kind and welcoming.

Our key findings were:

• There was a strong approach to safety of systems for reporting and recording incidents
• Information about services and how to complain was available and easy to understand.
• The provider routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on patient involvement with patient representatives actively involved in projects and audits.
• There was continuous learning and improvement at all levels of the organisation. The provider worked closely with their partner organisations to provide and improve care for their patient populations.
• Staff were very positive about working for the service and told us this was a fantastic place to work.
• Patient survey results were positive.
• The clinical areas were well organised and equipped.
• The provider assessed patients according to appropriate guidance and standards.
• Staff maintained the skills and competence to support the needs of patients. Staff were up to date with current guidelines.
• Risks to patients were well managed. For example, there were effective systems in place to reduce the risk and spread of infection. Medicines were stored appropriately.
• Systems were in place to deal with medical emergencies, staff were trained in basic life support and the provider had appropriate emergency medicines in place.
• Staff were kind, caring and put patients at their ease.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.

We saw that the treatment rooms at one of the services we looked at were clean and comfortable and promoted people's privacy and dignity. People were given information about their treatment and care and their views and comments were taken into account through surveys.

People were generally satisfied with their care and the professionalism of staff. People had their individual needs assessed before commencing care or treatment and were given detailed written information. The provider effectively dealt with incidents and risks.

Staff members demonstrated a good awareness of safeguarding, were able to discuss their actions in the event of a safeguarding concern and give examples of what may constitute abuse. The provider actively monitored people who were deemed as vulnerable and documented safeguarding issues appropriately.

Staff members were suitably qualified and had the skills and experience to keep people safe and meet their health and welfare needs.

The provider had a complaints process in place and staff were clear about their responsibilities for recording and dealing with complaints. People told us that they felt able to bring a concern or complaint to the direct attention of the staff member or manager, should the situation arise.