We carried out an announced comprehensive inspection on 20 September 2018 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 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.

Our key findings were:

• There were systems in place to keep patients safe and safeguarded from abuse.
• Risks well managed at the main Hub site we visited. The service recognised more assurances were required to ensure safety at other sites where care was also being delivered.
• Incidents were acted on and used to support learning.
• We visited only one of the 12 patient hubs which was located in a purpose-built health centre and appeared visibly clean and well maintained.
• There were systems in place to support infection, prevention and control and for managing the safety of equipment.
• The service did not dispence medicines but arrangements to manage emergencies and emergency medicines were in place.
• Appropriate processes were in place for the recruitment of staff. Staff were supported with their learning and development needs and had access to training and regular appraisals
• There was evidence of audits undertaken to ensure the quality of service.
• Patient information was shared as appropriate with relevant health and care professionals involved in the patients care and treatment and patients were informed.
• Feedback from people about the service they received was positive. People who had used the service felt involved in decisions and said that they were treated with dignity and respect.
• There was a complaints process in place and available on the provider website.
• There were established governance arrangements and strong leadership to support the running of the service. Meetings were held at various levels to review service quality.
• There was a strong focus on continuous learning, improvement and innovation at all levels of the organisation.
• The service had a fixed term five-year contract with the CCGs and had been able to demonstrate increased activity whilst demonstrating savings for the CCGs. This was achieved through various means such as service re-design (innovative patient pathways) involving a multidisciplinary team, increased community provision and innovative technology.

There were areas where the provider could make improvements and should:

• Review processes to gain assurance that all hub sites can deliver safe care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice