Latest Snippet(s)
Positive
"For example when medicines usually used in palliative or end of life care were being prescribed there were comments on the cost of the medicine the quantity and whether it was the responsibility of the out of hours service OOH to prescribe."
Latest Snippet(s)
Positive
"This was supported by GPs advanced nurse practitioners pharmacists and paramedics to ensure patients were appropriately signposted to the services across Gloucestershire."
Positive
"In addition to reports of shifts being cancelled by the service with short notice staff said that on occasion some advanced nurse practitioners were expected to work with other clinicians and then were told at the start of the shift that there were no GPs on shift."
2019-09-25 Snippet(s)
Positive
"• The lead nurse ensured that all Advanced nurse practitioners and emergency care practitioners worked within their scope of practice and had access to clinical support when required."
2018-10-24 Snippet(s)
Positive
"• The lead nurse ensured that all Advanced nurse practitioners and Emergency care practitioners worked within their scope of practice and had access to clinical support when required."
Positive
"They received mentorship and support from the lead nurse and GPs for this extended role."
Positive
"• The organisation employed Advanced nurse practitioners ANP who could prescribe medicines for clinical conditions within their expertise."
Neutral
"• Patient Group Directions were used by nurse practitioners and emergency care practitioners who were not able to prescribe."
Latest Snippet(s)
Positive
"Patients were asked to wait in their cars and the receptionist would then see them in the car to check their details before inviting them in to see a clinician for their appointment."
Latest Snippet(s)
Positive
"In response CQC is undertaking a series of coordinated inspections monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe effective and timely care."
Positive
"At this inspection we rated the service as requires improvement for providing safe services because: whilst some improvements had been observed there remained shortfalls in providing training in sepsis awareness planning and monitoring staffing levels and management of significant events."
Positive
"The monitoring of actions taken did not fully reduce the risk of a similar incident occurring again such as prescriptions going missing."
Positive
"• There were arrangements for planning and monitoring the number and mix of staff needed but these were not effective and actual numbers of staff working shift fill was declining over time."
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 were limited monitoring systems to ensure that learning required had been understood and acted upon."
2019-09-25 Snippet(s)
Positive
"• Local monitoring processes were in place to demonstrate whether each site had a health and safety infection prevention and safeguarding leads who had completed training in these areas of responsibilities."
Positive
"Performance was shared the local CCG as part of contract monitoring arrangements."
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 were arrangements for planning and monitoring the number and mix of staff needed."
2018-10-24 Snippet(s)
Positive
"Performance was shared with the local clinical commissioning group CCG as part of contract monitoring arrangements and a recovery plan was in place and actions were being taken."
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 were arrangements for planning and monitoring the number and mix of staff needed."
Neutral
"We saw that monitoring of the service was being carried out three hourly during operational hours."
Latest Snippet(s)
Positive
"There were arrangements and systems in place to support staff to respond to people with specific health care needs such as end of life care and those who had mental health needs."
Positive
"For example when medicines usually used in palliative or end of life care were being prescribed there were comments on the cost of the medicine the quantity and whether it was the responsibility of the out of hours service OOH to prescribe."
Positive
"Such as special notes for end of life care and safeguarding information."
2019-09-25 Snippet(s)
Positive
"There were arrangements and systems in place to support staff to respond to people with specific health care needs such as end of life care and those who had mental health needs."
2018-10-24 Snippet(s)
Positive
"There were arrangements and systems in place to support staff to respond to people with specific health care needs such as end of life care and those who had mental health needs."
Latest Snippet(s)
Positive
"• Managers reported that staff had onetoone meetings appraisals coaching and mentoring clinical supervision and support for revalidation."
2019-09-25 Snippet(s)
Positive
"This included onetoone meetings appraisals coaching and mentoring clinical supervision and support for revalidation."
Latest Snippet(s)
Positive
"This covered such topics as infection control health and safety and safeguarding."
2019-09-25 Snippet(s)
Positive
"For example: • The absence of a health and safety lead at the service had resulted in incomplete risk assessments and a lack of oversight or assurances that health and safety checks and actions had been completed."
Positive
"• The provider had a health and safety lead who delegated responsibility to other staff following health and safety training."
Positive
"Actions to provide a fire risk assessment and health and safety poster had been completed."
Positive
"• Local monitoring processes were in place to demonstrate whether each site had a health and safety infection prevention and safeguarding leads who had completed training in these areas of responsibilities."
Positive
"At the time of inspection all sites with their own policies except for one site whose health and safety lead had recently left."
Latest Snippet(s)
Positive
"We requested information on medicine prescribing audits and found that no information was provided on how this information was used to improve performance and what actions were being taken to ensure that medicines were being prescribed appropriately and when needed."
Positive
"• Information from medicine audits was not used effectively to improve performance."
Positive
"For example when medicines usually used in palliative or end of life care were being prescribed there were comments on the cost of the medicine the quantity and whether it was the responsibility of the out of hours service OOH to prescribe."
Positive
"The provider was unable to demonstrate fully how information from medicine audits and clinical audits was used to drive improvements."
Neutral
"There were six examples detailed in the service’s Datix related to handling of prescriptions and medicine management."
Neutral
"We were told that a clinician may have taken a risk with medicine security to try and save time when seeing patients in base."
Neutral
"There was no information on whether the service had considered the patient’s condition and the care and treatment they required which might have included prescribing these types of medicine to ensure symptoms such as pain and sickness were effectively controlled."
Neutral
"Other medicine used for the treatment of patients living with dementia had notes which queried why it was being prescribed in the OOH setting even though it was a repeat prescription request."
Neutral
"The provider was unable to demonstrate how the information from medicine audits was used to change or improve prescribing when needed."
2019-09-25 Snippet(s)
Neutral
"Monthly meetings were held with for example Emergency Departments the commissioners medicine management team to improve ways of working."
2018-10-24 Snippet(s)
Positive
"We did see though that medicine checks were documented and carried out regularly and supported good governance."
2019-09-25 Snippet(s)
Positive
"“Fidget packs” finger activities that may help alleviate Are services responsive to people’s needs?"
Neutral
"• Leaders had established policies procedures and activities but had not assured themselves that they were operating as intended."
2018-10-24 Snippet(s)
Positive
"• There were policies procedures and activities in place to ensure safety but the leaders had not assured themselves that they were operating as intended."
2019-09-25 Snippet(s)
Positive
"• We saw embedded governance processes included processes for communicating changes in national guidelines patient feedback clinical audit root cause analysis processes risk management and regular programme of meetings."