Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Vocare House on 10, 11, 14 and 30 January 2017. The overall rating for the service was requires improvement. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Vocare House on our website at www.cqc.org.uk.

This inspection was an unannounced focused inspection carried out on 20 October 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the service is now rated as good.

Our key findings were as follows:

• The service’s internal online training system had been redesigned and the sample of training records we looked at showed all clinical staff had recently carried out safeguarding training.
• The staff responsible for recruitment had been integrated into the human resource support team. This team supported regional and line managers with the administrative tasks associated with recruitment. The sample of recruitment records we looked at showed references had been obtained.
• Most training had been completed. Arrangements were in place to contact GPs to request copies of training certificates where they had completed this externally to the service.
• A large amount of appraisals for non-clinical staff had been carried out over the previous six months; staff had either had a recent appraisal or had a date booked within the following two weeks.

At our previous inspection in January 2017 we said the service should continue to seek ways to improve performance on face-to-face consultations. Performance was below average; the target was for 95% of consultations to take place within set timescales. The provider had achieved between 73% and 100% for the period April to September 2016. Plans were in place to improve, which included employing prescribing pharmacists and setting up a national triage team to cover periods of high demand. At this inspection we found that performance had improved and ranged from 94.3% to 100% of consultations taking place within the relevant timescales.

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 Vocare House on 10, 11, 14 and 30 January 2017. Overall the service is rated requires improvement.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need. The service met the National Quality Requirements.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Out of hours staff provided other services, for example the patient’s GP, with information following contact with patients as was appropriate.
• The service managed patients’ care and treatment in a timely way.
• 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.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• There was a clear leadership structure and staff felt supported by management. The service 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 areas where the provider must make improvements are:

• Ensure all staff receive training appropriate to their role including children’s safeguarding, basic life support and infection control. Ensure all staff receive appropriate support, including regular supervision and appraisals.

• Ensure oversight and governance arrangements are in place to provide assurance that; recruitment processes are safe and that action is taken to address areas of known concern, including the monitoring and recording of staff training requirements.

In addition, the provider should:

• Continue to seek ways to improve performance on face-to-face consultations.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice