CQC Inspection Report

Our CQC report has been published today on the CQC website following an inspection visit over 10th and 12th March 2014.

We feel the report presents a very balanced picture and are delighted that it recognises our deep rooted commitment to patient care, experience and continual improvement. This briefing paper highlights a selection of the many positive observations made by the inspection team regarding the service, the areas where they felt we could improve and also some of the actions we already have, and will, be taking to enhance our services further.

The report captures the enormous effort and expertise all staff, working at every level, put into their work and are delighted that the national inspection team have recognised this during their visit.

As part of the inspection, the team interviewed a number of patients and observed staff and patient interactions. They reported that all the comments made by patients were positive about GTD, in particular praising the caring and friendly nature of the staff. Examples include:

"I feel safe when I’m using the service, staff are excellent and efficient”

"the service is easily accessible and the staff are fine, I always feel like I am put in the picture and you know what’s going on”

"the staff here are very good and you are seen quickly”.

We are especially delighted that the report highlighted, without exception, that the team observed staff acting in a kind and sympathetic manner and maintained patient’s dignity and confidentiality at all times. Patients reported that they felt they had been involved in decisions about their care and the doctors communicated fully and clearly with them.

We work hard to help support the wider health system and this was recognised by the inspection team, as they reported how we are proactive and cooperative in discussions about how to reduce the pressures on the local accident and emergency departments.

Our efforts to respond to people with a wide variety of needs and from a diverse demography and geography were positively acknowledged, and the inspection team particularly highlighted our engagement work with Healthwatch and local voluntary providers as an area of good practice in working with our communities.

The leadership of the organisation was commended with the team commenting on the strong and stable management structure and how the leadership take responsibility for the services provided. They praised the experience and knowledge of the senior staff and Board, and felt there was a good relationship between clinical and non clinical staff.

Feedback from staff described a culture within the organisation that focused on patient care and staff reported feeling supported by team leaders. They were also positive about the training, induction and personal and professional development opportunities available to them.

The team found that controlled drugs were stored, recorded and checked well and discussions with staff demonstrated there was an understanding that knew they about the correct safeguarding procedures, and in particular what to do should they suspect anyone was at risk of harm.

They also observed that the physical environment was well maintained with staffing levels at both the call centre and treatment centres at levels that matched the demands on the service at the time.

The team were complimentary about our recruitment procedures with thorough checks in particular being done on GPs to ensure their professional registration and performers list were satisfactory. GPs that were interviewed reported that they felt supported by the organisation and received regular updates, training, newsletters and opportunities to attend clinical meetings.

he inspection highlighted that our clinical audit systems were effective in ensuring that patients received high quality care and treatment. We were pleased that they recognised the relationships GTD had developed with other healthcare and social care providers such as social services, district nursing, acute hospital and ambulance services. They recognised that this close collaboration helped to ensure patients were provided with co-ordinated patient centred care.

Along with many areas of good practice the team also identified a small number of areas they felt could be improved. Thankfully none of the areas identified for more work were complete surprises and were areas already identified internally to improve upon. In particular, the team identified improvements that could be made to the management of non-emergency medicines. We weren’t as robust as we could be in our system of monitoring the temperature of the medicine fridge and we can improve the accuracy of the stock control of our non-emergency drugs packs. We don’t store medicines that are temperature sensitive and so have been able to address some of this already by removing the medicine fridge altogether.

While all of our GPs have received safeguarding training, the team found some discrepancies between the level of safeguarding training some of our GPs have had and the level of training we have set as a standard.

In conclusion, we really value the feedback from the process on all the areas the CQC team looked at and are already busy working up detailed and deliverable action plans to improve all aspects of what we do as a result. This will not only include the areas the CQC want further feedback on but also others that we feel are equally important.

The full report can be found via the CQC website.

Any questions or queries please do get in touch by contacting David Beckett, Chief Executive, or Dawn Sewards, Head of Governance and Clinical Leadership. David and Dawn can be reached via their respective email address david.beckett@nhs.net and dawn.sewards@nhs.net or phone on 0161 337 2241 or 0161 337 2253.