Latest Snippet(s)
Neutral
"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."
2016-10-04 Snippet(s)
Positive
"Management monitoring and improving outcomes for people The provider carried out various audits in relation to this service which included audits of syringe drivers for use in end of life care and workload patterns across Derbyshire and Derby City."
Positive
"• There were procedures in place for monitoring and managing risks to patient and staff safety."
Neutral
"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."
2016-04-12 Snippet(s)
Positive
"Management monitoring and improving outcomes for people The provider was monitored against the National Quality Requirements NQRs for OutofHours providers that capture data and provide a measure to demonstrate that a service is safe clinically effective and responsive."
Positive
"• There was a nurse lead for medicines management who took overall responsibility for arranging the storage supply and monitoring of medication with link nurses responsible for managing stock at each primary care site."
Positive
"• A rota management team were responsible for planning and monitoring the number of staff needed to meet patients’ needs including GPs nurse practitioners and drivers."
Positive
"• There were procedures in place for monitoring and managing risks to patient and staff safety."
Neutral
"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."
Neutral
"Monthly contract monitoring meetings and Clinical Governance meetings were held as well as weekly conference calls."
2016-04-12 Snippet(s)
Positive
"A manager was responsible for monitoring these reports on a daily basis to ensure targets were achieved and liaised with the rota team to ensure staffing levels were sufficient."
Positive
"• A rota management team were responsible for planning and monitoring the number of staff needed to meet patients’ needs including call advisors and clinical advisors."
Positive
"• A programme of continuous clinical and internal audit was in place which was used to monitor quality and to make improvements including continual auditing of call advisors telephone calls and monitoring individual use of the NHS Pathways."
Positive
"• There were procedures in place for monitoring and managing risks to patient and staff safety."
Positive
"DHU monitored its performance daily against the Minimum Data Set MDS and Key Performance Indicators KPIs some of which were locally agreed and this was discussed with the lead for the CCG and DHU managers at weekly conference calls and monthly contract monitoring meetings."
Neutral
"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."
Neutral
"• There was evidence of appraisals performance monitoring processes and personal development plans were in place."
Neutral
"Performance was discussed with the lead for each Clinical Commissioning Group and DHU managers at weekly conference calls and monthly contract monitoring meetings."
Neutral
"This was discussed with the lead for the CCG and DHU managers during weekly conference calls and monthly contract monitoring meetings."
Neutral
"Weekly conference calls and monthly contract monitoring meetings were held with each Clinical Commission Group."
2014-05-07 Snippet(s)
Neutral
"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."
2014-05-07 Snippet(s)
Neutral
"The Clinical Audit Committee also fed back to the Clinical Governance Committee on the results of its audits into areas such as safeguarding adults appropriateness of home visit requests and medicine management."
2016-10-04 Snippet(s)
Positive
"Outstanding practice We saw several areas of outstanding practice including: • A daily comfort call system was in place for patients referred into this service with palliative care needs and those patients who were at the end of their life."
Positive
"We saw several areas of outstanding practice including: • A daily comfort call system was in place for patients referred into this service with palliative care needs and those patients who were at the end of their life."
Positive
"There was a comprehensive stock of medicines which included drugs for use in palliative care held at all primary care centres and also within GP outofhours vehicles."
Positive
"• A daily comfort call system was in place for patients referred into this service with palliative care needs and those at the end of their life."
Positive
"A daily comfort call system was in place for patients referred into this service with palliative care needs and end of life patients."
Positive
"• Multidisciplinary meetings took place which included representation from Macmillan nurses palliative care Consultants GPs and the day time district nursing service for patients with complex needs patients at end of life or receiving palliative care."
Positive
"For example staff had undertaken training in verification of patient death end of life care domestic abuse awareness dementia awareness decision making for patients at end of life and foundations in palliative care which covered pain and symptom control and bereavement."
Positive
"• A ‘palliative care group’ was in place and meetings were held on a regular basis to review any complaints incidents lessons learned or training requirements of the nursing team in relation to all palliative care patients."
Positive
"• All members of the nursing team received training specific to their role such as in end of life care palliative care Mental Capacity Act MCA and Deprivation of Liberty Standards DoLS."
Neutral
"The provider had ensured staff had access to training specific to their roles which included end of life palliative care and verification of patient death."
2016-04-12 Snippet(s)
Positive
"The GPs had received palliative care training."
2016-10-04 Snippet(s)
Positive
"Where a district nurse was unavailable to verify a patient death either the clinical lead on duty or an outofhours GP would be called to attend to verify the patient death."
Positive
"Each visiting team consisted of a nurse and a health care assistant or two nurses."
Positive
"The coordinator was also aware if a nurse’s toughbook signal was poor and would attempt to contact the nurse by telephone to check they were safe."
2016-04-12 Snippet(s)
Positive
"• There was a nurse lead for medicines management who took overall responsibility for arranging the storage supply and monitoring of medication with link nurses responsible for managing stock at each primary care site."
Positive
"DHU also employs salaried GPs nurse practitioners health care assistants phlebotomists drivers and were supported by coordinators and nonclinical staff."
Positive
"There was an infection control clinical lead nurse who was responsible for carrying out the infection control audits."
Positive
"During our inspection we found that full prescription pads were recorded at Ashgate Manor by a link nurse when being distributed to another primary care location at Buxton Hospital."
Positive
"• A rota management team were responsible for planning and monitoring the number of staff needed to meet patients’ needs including GPs nurse practitioners and drivers."
Positive
"• The learning needs of staff were identified through ongoing assessments and meetings and a system of appraisals was in place for example all advanced nurse practitioners ANPs received their appraisal by the ANP team leader who was a senior nurse."
Neutral
"The team included a GP specialist advisor a second CQC inspector and a practice nurse specialist advisor."
Neutral
"We were told that a nurse practitioner and a GP checked the CD cabinets on a weekly basis."
Neutral
"For example nurse practitioners received clinical supervision from trained clinical supervisors."
Neutral
"This was discussed with nurse practitioners at a link nurse meeting."
2016-04-12 Snippet(s)
Positive
"This employee told us that they had undergone ten supervised shifts as a nurse advisor and had received comprehensive training and support and was currently awaiting being signed off before they could work unsupervised with the support of a ‘buddy’."
Positive
"• Call advisors were supported by nurse advisors dental nurses and paramedics to provide clinical support in decision making."
Positive
"• The provider employed agency nurse advisors who were clinically trained in NHS Pathways to ensure there was adequate clinical cover within the call centre to ensure the safety of patients."
Positive
"• Calladvisors were supported by nurse advisors dental nursesand paramedics to provide clinical support in decision making."
Positive
"DHU employed agency nurse advisors who were clinically trained in NHS Pathways to ensure there was adequate clinical cover within the call centre to ensure the safety of patients."
Positive
"• Call advisors were supported by a mental health nurse funded by Derbyshire NHS Mental Health Trust based in the call centre on Fridays Saturdays and Sundays."
Positive
"• Calladvisors were supported by a mental health nurse funded by Derbyshire NHS Mental Health Trust based in the call centre on Fridays Saturdays and Sundays."
Positive
"It is expected that DHU will improve this target due to the increase in the availability of nurse advisors."
Positive
"• Agency nurse advisors trained in NHS Pathways were employed to ensure sufficient staffing levels to meet the demand of patient calls and to support call advisors within the call centre."
Positive
"The patient had received a call back from a nurse advisor before being given an appointment at an OutofHours primary care centre."
Neutral
"We spoke with a nurse advisor who told us that they had received three call review audits per month feedback was delivered on the outcome of the call reviews by a member of the management team."
Neutral
"Calls could be transferred directly to a clinical advisor for advice such as a nurse or paramedic."
Neutral
"The provider ensured that the nurse advisors participated in revalidation."
2014-05-07 Snippet(s)
Positive
"An advanced nurse practitioner told us that DHU conducted supervision of all nurses aimed at supporting staff enhancing knowledge and encouraging reflective practice and continuous improvement."
Positive
"Their comments included; “The nurse told us what was going to happen and talked with my child which put them at ease.”"
Positive
"We were provided with a copy of the induction program and we talked with an advanced nurse practitioner and trainer who explained in detail how the induction process worked and how they observed staff’s practice to assess their competence."
Neutral
"It took place over two days with a team that included two CQC inspectors a GP a GP practice manager a nurse and an expertbyexperience."
Neutral
"The team included an additional CQC Inspector a GP practice manager a nurse and an expertbyexperience who helped us to capture the experiences of patients who used the service."
Neutral
"We also visited Chesterfield Royal Hospital and spoke with GP and nurse practitioner who were working there."
Neutral
"We observed a nurse talking with a child and parent who were waiting to be seen by a clinician about what was happening."
Neutral
"We heard how the nurse communicated with the child at a level they could understand."
2016-10-04 Snippet(s)
Positive
"All compliments received related to the high level of care received from the nursing team in particular from families of those patients who were at end of life and had thanked the staff for what they described as outstanding end of life care delivered to their loved ones."
Positive
"Management monitoring and improving outcomes for people The provider carried out various audits in relation to this service which included audits of syringe drivers for use in end of life care and workload patterns across Derbyshire and Derby City."
Positive
"DHU engaged with partner organisations within these groups with an aim to be actively involved in service development to improve end of life care across Derbyshire."
Positive
"For example staff had undertaken training in verification of patient death end of life care domestic abuse awareness dementia awareness decision making for patients at end of life and foundations in palliative care which covered pain and symptom control and bereavement."
Positive
"For example staff had undertaken training in varying aspects of end of life care dementia awareness and domestic abuse awareness."
Positive
"• All members of the nursing team received training specific to their role such as in end of life care palliative care Mental Capacity Act MCA and Deprivation of Liberty Standards DoLS."
2016-10-04 Snippet(s)
Positive
"Significant incidents were investigated by the clinical governance leaddeputy lead and discussed with the Clinical Commissioning Group quality lead."
2016-04-12 Snippet(s)
Neutral
"• The provider had a corporate induction programme for newly appointed members of staff that covered such topics as integrated clinical governance information governance fire safety health and safety and equality and diversity."
2016-04-12 Snippet(s)
Positive
"Significant incidents and serious incidents were investigated by the clinical governance leaddeputy lead and discussed with the Clinical Commissioning Group quality lead."
Neutral
"• The provider had a corporate induction programme for newly appointed members of staff that covered such topics as integrated clinical governance information governance fire safety health and safety equality and diversity."
2016-10-04 Snippet(s)
Positive
"• There was evidence of clinical audit clinical supervision and reflective feedback processes for all staff to ensure the delivery of high quality patient care."
2016-04-12 Snippet(s)
Positive
"• There was evidence of clinical audit clinical supervision and reflective feedback processes for all clinical staff to ensure the delivery of high quality patient care."
2014-05-07 Snippet(s)
Positive
"Clinicians had been subject to continuing clinical audit and supervision to ensure their effectiveness in delivering good quality care and treatment."
Positive
"There was a rigorous clinical audit and appraisal process for GP’s and other clinicians aimed at identifying and addressing any clinical issues."
Positive
"We judged that the clinical audit system was robust and effective in ensuring that patients continued to receive effective high quality care and treatment."
Positive
"Our findings DHU operated a rigorous clinical audit system to continually improve the service and deliver the best possible outcomes for patients."
2016-10-04 Snippet(s)
Positive
"• There was evidence of clinical audit clinical supervision and reflective feedback processes for all staff to ensure the delivery of high quality patient care."
Positive
"• A programme of continual appraisal clinical supervision and performance management was in place to ensure a high level of patient care was delivered."
Positive
"• There were clinical supervision and appraisal processes in place for all clinical roles and support was provided for those members of the nursing team who were required to revalidate."
2016-04-12 Snippet(s)
Positive
"• There was evidence of clinical audit clinical supervision and reflective feedback processes for all clinical staff to ensure the delivery of high quality patient care."
Positive
"• There was excellent clinical supervision and appraisal processes in place for all clinical roles including regular audit of individual’s clinical practice and reflective feedback."
Positive
"All newly recruited GPs received a four hour initial induction within the primary care centre this induction included an overview of the Adastra clinical system and a clinical supervision session."
Positive
"A process was in place to ensure any areas of underperformance were addressed this included regular clinical supervision sessions and assessment of patient care and delivery of treatment and clinical advice."
Positive
"• A programme of continual appraisal clinical supervision and performance management was in place to ensure a high level of patient care was delivered."
Positive
"A programme of additional clinical supervision sessions had been arranged for the clinician involved to address issues arising from the complaint."
Positive
"All clinical staff received a high level of continual clinical supervision and audit of their competencies."
Neutral
"For example nurse practitioners received clinical supervision from trained clinical supervisors."
Neutral
"• All nurses received clinical supervision from senior ANPs."
2016-04-12 Snippet(s)
Positive
"• A programme of continual appraisal clinical supervision and performance management was in place to ensure a high level of patient care was delivered."
Positive
"All clinical staff received a high level of continual clinical supervision and audit of their competencies."
2016-10-04 Snippet(s)
Neutral
"• The provider had a corporate induction programme for newly appointed members of staff that covered such topics as information governance fire safety health and safety and equality and diversity."
2016-04-12 Snippet(s)
Positive
"The provider was not assessing the risks to the health and safety of service users of receiving the care or treatment or doing all that is reasonably practicable to mitigate any such risks."
Neutral
"• The provider had a corporate induction programme for newly appointed members of staff that covered such topics as integrated clinical governance information governance fire safety health and safety and equality and diversity."
2016-04-12 Snippet(s)
Positive
"During our inspection a member of staff showed us where policies and procedures could be found we saw evidence of a health and safety policy and a COSHH control of substances hazardous to health policy on the intranet which was available for all staff."
Neutral
"• The provider had a corporate induction programme for newly appointed members of staff that covered such topics as integrated clinical governance information governance fire safety health and safety equality and diversity."
2016-04-12 Snippet(s)
Positive
"• At one location patients could use an intercom system at the main entrance to alert the receptionist of their arrival the secured doors automatically opened for patients to enter."
Neutral
"For example a receptionist we spoke with had begun training to become a HCA as part of a pilot scheme which involved HCAs working on a weekend."
2016-04-12 Snippet(s)
Positive
"• We conducted a tour of the three primary care centres and looked at vehicles used to transport clinicians to consultations in patients’ homes."
Neutral
"• There were emergency medicines available in each primary care centre and in the vehicles used to transport GPs to consultations in patients’ homes."
2014-05-07 Snippet(s)
Positive
"It is registered with the Care Quality Commission to provide the regulated activities of transport services triage and medical advice provided remotely and the treatment of disease disorder and injury."
Neutral
"We conducted a tour of two treatment centres and looked at the vehicles used to transport clinicians to consultations in patients’ homes."
2016-04-12 Snippet(s)
Positive
"• The provider had a mandatory training programme that covered topics such as basic life support safeguarding adults and children and infection prevention and control and Mental Capacity Act training."
2014-05-07 Snippet(s)
Positive
"We saw evidence of both internal and external audits in infection prevention and control aimed at helping to highlight any area of concern or areas for improvement."
2014-05-07 Snippet(s)
Neutral
"We looked at the equipment carried in the vehicles that could be used by a GP in the event of a medical emergency and found it to be appropriate well maintained and checked regularly."
2014-05-07 Snippet(s)
Positive
"It is registered with the Care Quality Commission to provide the regulated activities of transport services triage and medical advice provided remotely and the treatment of disease disorder and injury."
2014-05-07 Snippet(s)
Positive
"We saw the treatment centres were accessible to people with restricted mobility such as wheelchair users and that patient accessible areas were in very good condition."