This service is rated as Good overall. (Previous inspection February 2018 - Inadequate)

The key questions now 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 inspection at i-Heart 365 Service - Extended Hours service on 14, 16 and 17 November 2018 to follow up on breaches of regulations and inspect a service in special measures. 

We previously carried out an announced comprehensive inspection of the service on 13 and 14 February 2018. Our overall rating for the service was inadequate and inadequate for providing safe, effective, responsive and well-led services, it was rated as good for caring. We served warning notices for breaches in relation to Regulation 16: Receiving and acting on complaints and Regulation 18: Staffing. 

At this inspection we found:

• The service had reviewed the systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service had introduced systems to review the effectiveness and appropriateness of the care it provided. It had ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.

We observed one area of outstanding practice:

• The provider had reviewed the identification and management of sepsis across all its services and routinely recorded patient observations in the face to face settings to calculate early warning scores. They had been proactive by sharing and promoting this work with other organisations across healthcare pathways and had contributed to the review of external incidents relating to sepsis led by other organisations.

The areas where the provider should make improvements are: 

• Review checking of emergency medicines and equipment in line with the Resuscitation Council UK guidelines.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice