Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Resolution Health Centre on 14 December 2016. The overall rating for the practice was good but requires improvement in safe. The full comprehensive report of the 14 December 2016 inspection can be found by selecting the ‘all reports’ link for Resolution health Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 14 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good.

Our key findings were as follows:

• Since the previous inspection the practice had purchased and installed data loggers (automatic temperature monitors) within the vaccine fridges. We did however find that there were some gaps in recording of fridge temperatures. Also that the data from the data loggers showed the temperatures had gone out of the required range and had not been identified.

• Since the last inspection the practice had implemented additional checks in respect of infection prevention and control. However, no full infection control audits have been completed.

  The provider MUST make improve;

Have effective arrangements in place to ensure that vaccines and other medicines stored in the refrigerators are stored at the correct temperatures.

The practice SHOULD:

• Implement infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Resolution Health Centre, 16 December 2016. The practice, which provides a service to registered patients as well as Walk-in patients, is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Risks to patients were assesses and well managed with the exception of those relating to the management of medicines.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day and pre bookable appointments available.

• The practice is an Alternative Provider Medical Services (APMS) and is open seven days a week and offers a walk in service to registered and unregistered patients in the area.

• The practice had arrangements in place to ensure continuity of care by referring patients back to their registered GP when indicated following treatment at the Walk-in centre.

• Feedback from patients about their care was consistently positive.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure in place. The practice proactively sought feedback from staff and patients, which it acted on. The provider was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

The provider MUST make improve;

• Ensure there are effective arrangements in place to ensure that vaccines and other medicines stored in the refrigerators are stored at the correct temperatures and appropriate records are maintained.

The practice SHOULD:

• Implement infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Over the last two years we have inspected every Trust registered hospital and community base. We have completed annual inspections of the James Cook University Hospital and The Friarage as well as completing themed inspections at the hospitals, which looked at both Accident and Emergency departments as well has the Trust’s termination of pregnancy services. We found that the Trust encouraged us to identify any ways they could improve.

Teams of CQC staff have inspected all the locations and these teams included specialist advisors and experts by experience. Throughout the two years we have held regular meetings with Trust representatives and discussed work the Trust is completing to maintain and improve their service. We have found that over the two years the Trust has remained compliant with all the regulations.

Our central analytic team have constantly reviewed the data the Trust has submitted to the various bodies overseeing their work and used this to assess the performance of the Trust. The central team have also compared this information on performance against other Trusts both in the North East, across the country and against Trusts with similar size populations and services. The last published risk rating for the Trust placed them in band 6, which is the lowest risk rating.

We found that the Trust’s quality assurance system was effective. It covered all aspects of the service and did not lose sight of the needs of the patients using the community services.

We decided to visit the health centre on a Saturday morning to gain a wider view of the service provided. This was part of an out of normal hours pilot project being undertaken in the North East region. At this inspection we concentrated on the walk-in centre and did not review any aspect of the GP practice.

We observed the service, spoke with 12 patients and all of the clinical staff as well as the administration staff. We found that the patients were extremely happy with the walk-in centre service. They told us “The staff are brilliant and they really listen to you.", "I have come to the walk-in centre a good few times and always find the staff are spot on.”, “It is great as I can quickly get to see a doctor.” and “I come here because I know they will see you as quickly as they can.”

The patients used the walk-in services for a range of minor illnesses and injuries. We found staff ensured patient's GP was made aware of the contact within four hours of their visit. This ensured that the patient’s GP provided continuity of care. We found that patients were involved in decisions about the treatment they received at the walk-in centre.

From the information we reviewed and our discussions we found that the walk-in centre effectively supported acute services within the trust. We found that over 200 patients were seen within each day and the staff were adept at treating people. Where appropriate patients were referred to the local minor injury and A&E departments.