This service is rated as Good overall. (Previous inspection March 2018- rated as meeting the requirements for all domains).

We inspected Wrightway Health Limited in October 2017 and found the provider was not providing safe services. We found there were breaches of regulation 17 (good governance). At our last inspection in March 2018, we followed up on this breach of regulation and found the provider had met the requirements and the issues had been resolved.

We carried out an announced comprehensive inspection at Wrightway Health Limited on 15 May 2019. This inspection was to rate the service.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Wrightway Health Ltd, occupational health schemes (that do not involve treatment requiring admission to hospital) organised through an employer, where these are for the benefit of the employee only are exempt from regulation. Wrightway Health Ltd offers other specialist services and treatments such as first aid coaching and fit mask testing (mask fitting for people with jobs which may cause respiratory complications) which are also exempt from regulation.

Wrightway Health Limited is registered with the Care Quality Commission to provide services at Wrightway Health Ltd, West Site, Norwich Research Park, Norwich, NR4 7UA. These services include health assessments and travel vaccinations. The clinic is based close to the city centre of Norwich in a quiet residential area. The provider also uses clinic rooms in Great Yarmouth, Cambridge, Kings Lynn, Bury St Edmunds and Ipswich. The main property in Norwich consists of a patient waiting room, reception area, administration office and consulting rooms which are located on the ground floor of the property. There is on site car parking at all sites.

The provider holds a list of corporate clients and offers services to patients who reside in East Anglia and surrounding areas but also to patients who live in other areas of England who require their services.

The service is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury.

The lead doctor 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.

As part of our inspection we asked for CQC comment cards to be completed by clients prior to our inspection visit. We received 36 comment cards, 34 of which were wholly positive about the service. The cards reflected the kind and caring nature of staff, how informative staff were, the pleasant environment and the positive manner of the clinicians. Other forms of feedback, including patient surveys and internet feedback was consistently positive.

Our key findings were:

• We saw there was leadership within the service and the team worked together in a cohesive, supported, and open manner.
• There was an effective system in place for reporting and recording significant events, particularly information governance events.
• Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• Risks to patients were assessed and monitored.
• The service held a range of policies and procedures which were in place to govern activity; staff were able to access these policies easily and staff had signed each one.
• To ensure and monitor the quality of the service and their record keeping, the service undertook regular audits of patient records.
• Staff assessed patients’ needs and delivered care in line with current evidence-based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• All patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.

The areas where the provider should make improvements are:

• Improve the documentation of fridge temperatures to support the safe storage of vaccines.
• Embed the system for the receiving and action of patient safety alerts.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced focussed inspection on 12 March 2018 to ask the service the following key question; Are services safe?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Background

We carried out an announced comprehensive inspection at Wrightway Health Limited on 10 October 2017. The service was rated as meeting the regulations for providing effective, caring, responsive and well led services, and not meeting the regulations for providing safe services as a breach of regulation 17 (good governance) was found. The full comprehensive report following the inspection on 10 October 2017 can be found by selecting the ‘all reports’ link for Wrightway Health Limited on our website at www.cqc.org.uk.

We undertook a follow up focused inspection of Wrightway Health Limited on 12 March 2018. This inspection was carried out to review in detail the actions taken by the service to improve the quality of care and to confirm that the provider was now meeting legal requirements.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Wrightway Health Ltd services are provided to patients under arrangements made by their employer. Some of these types of arrangements are exempt by law from CQC regulation. Therefore, at Wrightway Health Ltd, we were only able to inspect the services which are not arranged for patients by their employers with whom the patient holds a policy (other than a standard health insurance policy).

Wrightway Health Ltd is an independent provider of occupational health services and also offers a range of specialist services and treatments such as first aid coaching and fit mask testing (mask fitting for people with jobs which may cause respiratory complications) to people on a pre-bookable appointment basis.

Wrightway Health Limited is registered with the Care Quality Commission to provide services at Wrightway Health Ltd, West, Site, Norwich Research Park, Norwich, NR4 7UA. The clinic is based close to the city centre of Norwich in a quiet residential area. The provider also uses clinic rooms in Great Yarmouth, Cambridge, Bury St Edmunds and Ipswich. The main property in Norwich consists of a patient waiting room, reception area and administration office and consulting rooms which are located on the ground floor of the property. Further administration and meeting rooms were available on the first floor. There is on site car parking at all sites.

The provider holds a list of corporate clients and offers services to patients who reside in East Anglia and surrounding areas but also to patients who live in other areas of England who require their services.

The lead doctor 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.

The provider employs seven doctors; one doctor is also the Director of the company and is responsible for the overall management of the clinics, three nurses and seven occupational health technicians. The clinical team are supported by a team of administration and management staff. The provider had recently employed an operations manager to further enhance the team.

The site is open from 8am until 5pm Monday to Friday.

The provider is not required to offer an out of hour’s service. Patients who need emergency medical assistance out of corporate operating hours are advised to seek assistance from alternative services such as the NHS 111 telephone service or accident and emergency. This is detailed on the website and its patient guide.

Our key findings were:

• All doctors and management staff were trained to safeguarding level three.
• All clinicians had received enhanced disclosure and barring checks.
• All equipment we checked was in date. There was a new policy in place to support this and a new system to manage equipment had been implemented.

We carried out an announced comprehensive inspection on 10 October 2017 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 not 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.

Background

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Wrightway Health Ltd services are provided to patients under arrangements made by their employer. Some of these types of arrangements are exempt by law from CQC regulation. Therefore, at Wrightway Health Ltd, we were only able to inspect the services which are not arranged for patients by their employers with whom the patient holds a policy (other than a standard health insurance policy).

Wrightway Health Ltd is an independent provider of occupational health services and also offers a range of specialist services and treatments such as first aid coaching and fit mask testing (mask fitting for people with jobs which may casue respiratory complications) to people on a pre-bookable appointment basis.

Wrightway Health Limited is registered with the Care Quality Commission to provide services at Wrightway Health Ltd, West, Site, Norwich Research Park, Norwich, NR4 7UA. The clinic is based close to the city centre of Norwich in a quiet residential area. The provider also uses clinic rooms in Great Yarmouth, Cambridge, Bury St Edmunds and Ipswich. The main property in Norwich consists of a patient waiting room, reception area and administration office and consulting rooms which are located on the ground floor of the property. Further administration and meeting rooms were available on the first floor. There is on site car parking at all sites.

The practice holds a list of corporate clients and offers services to patients who reside in East Anglia and surrounding areas but also to patients who live in other areas of England who require their services.

The lead doctor 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.

As part of our inspection we reviewed 20 of the providers comment cards, collected between February and August 2017, where patients and members of the public shared their views and experiences of the service; 17 of the cards were positive about the service experienced. Patients said the practice offered an excellent service and staff were helpful, caring and treated them with dignity and respect. Comments also stated that the environment was calm, safe, clean and hygienic. Patients told us they received information to help them make informed decisions about their care and treatment. The three comment cards with mixed feedback related to the forms that required filling in prior to consultation. Comments related to the time it took to fill these in and repetitiveness of the forms.

The provider employs seven doctors; one doctor is also the Director of the company and is responsible for the overall management of the practice, three nurses and seven occupational health technicians. The clinical team are supported by a team of administration and management staff.

The site is open from 8am until 5pm Monday to Friday.

The provider is not required to offer an out of hour’s service. Patients who need emergency medical assistance out of corporate operating hours are advised to seek assistance from alternative services such as the NHS 111 telephone service or accident and emergency. This is detailed on the practice website and its patient guide.

Our key findings were:

• There was an effective system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand. Complaints were fully investigated and patients responded to with an apology and full explanation.
• Staff had not received a Disclosure and Barring Service (DBS) check and no formal, documented risk assessment had been conducted in relation to this. The provider stated they had been told they were not required to have a Disclosure and Barring Service check, however after the inspection they sought further advice and informed us they would be undertaking these checks for all clinical staff.
• Risks to patients were usually assessed and well managed. However, we found some out of date equipment at one site.
• The practice held a comprehensive central register of policies and procedures which were in place to govern activity; all staff were able to access these policies.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. 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.

Areas where the provider must make improvement:

• Ensure effective systems and processes are established in relation to good governance in accordance with the regulations and fundamental standards of care.

Areas where the provider could make improvements and should:

• All doctors should be working toward achieving level 3 training in child safeguarding.