We carried out an announced comprehensive inspection on 30 November 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.

Qure Limited is a small organisation that offers a dermatology service to people who are referred by their GP.

The GP providing the service 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.

Our key findings were:

• The service had clear systems to manage risk so that safety incidents were less likely to happen. There was a process in place to enable the service to learn from incidents and improved their processes if incidents occurred. We found no incidents had occurred in the previous 12 months.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The GP maintained the necessary skills and competence to support the needs of patients and was up to date with all required training.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found it easy to access appointments and reported that they were able to access care when they needed it.
• Systems and processes were in place for managing governance in the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

In our previous inspection we found that there were not effective systems in place to reduce the risk and spread of infection.

In response the provider had sent us an action plan telling us how they would ensure the above standard was met. We visited Hessle Grange Medical Practice and spoke with the providers about the improvements made. We reviewed their action plan, inspected the premises to check the improvements had been made and looked at other relevant documentation.

At this visit we saw the provider had taken steps to ensure people received treatment in a clean, hygienic environment and were protected from the risk of infection because appropriate guidance had been followed.

The provider informed us that the service undertakes approximately 30 procedures each year. They were able to discuss and provide documents in relation to the assessment of patients and the treatment procedures they undertook.

Some of the people who used the service spoke with us and told us they were happy with the service they had received, they felt the environment was clean and that their privacy had been maintained. They said, “I was fully satisfied with everything” and “ I was extremely happy.”

The location provided suitable rooms to meet people’s needs and the provider ensured that equipment was available for the procedure undertaken. However infection control procedures were found to be lacking and the main piece of equipment was dirty. Infection control and cleaning audits were not undertaken and information was not resourced by the provider to assure themselves of the integrity of the cleaning of the environments.

However quality audits for patient care were in place alongside of procedures for handling any untoward incidents or complaints.

We asked the provider to view patient records but they declined to make these available. However we were provided with the contact details of three previous patients and were able to speak with two of these .

Both of these people said they had been fully informed about the procedures they had looked at and were happy with the levels of support and information provided by the service. We had confirmed to us that people's needs were met and that they felt safe whilst under going any treatment.

The provider told us about the systems in place to ensure that people's consent was recorded and people were informed of the treatments and side effects. They told us how they ensured that their practice assessed risks and how people were protected.

They told us about the systems in place to help protect vulnerable people and how people could complain about the service if they wished to do so.