We previously inspected the service on the 24 February 2017 and found the service was not meeting some of the regulations. We carried out an announced focussed inspection on 24 November 2017 to follow up on breaches of regulations and we asked the service the following key questions: are services safe, effective and well-led?

Dr Morton’s The Medical Helpline offers patients medical advice and treatment via an online platform. Patients access the services via Dr Morton’s website www.drmortons.co.uk and can request consultations with a doctor via email or telephone. Patients can pay for these services by direct debit, which offers an unlimited service for a set payment per month, or by paying for an individual consultation. Patients can also order direct supply medicines from a small selection available via the provider’s website. A registered manager is in place. 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.

Our findings in relation to the key questions are as follows:

Safe:

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

• The provider had risk assessed the systems in place to check the identity of patients. The risk assessment included correctly identifying the patient, recording calls and keeping the patient’s registered NHS GP informed.
• Lead roles were clear within the organisation and were displayed within the office. The safeguarding lead was named in the safeguarding policy.
• Training records were up to date and a training matrix was in place to monitor staff training. Nearly all of the clinicians at the time of the inspection had received appropriate training in safeguarding children. There was one clinician that was level two trained and was in the process of receiving level three training. We received evidence after the inspection that this training had now been completed.

Effective:

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

The service had a system in place for clinical quality improvement. Clinical audits had been carried out and we saw evidence to show improvements had been made.

Well-led:

We found that this service was providing well-led care in accordance with the relevant regulations.

• Policies we looked at were up to date and aligned with working practice within the organisation.
• The provider had a system in place to capture patient feedback and there was evidence to demonstrate the provider had responded to feedback and made improvements to the service.

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

CQC inspected the service on 24 February 2017 and asked the provider to make improvements regarding their arrangements for:

• Risk assessing the system used for checking patients’ identities.
• Monitoring staff training.
• Keeping policies up to date and reflective of the service.
• Ensuring lead roles within the service were clear.
• Ensuring staff had training relevant to their role.
• Ensuring there was a system in place to seek and act upon patient feedback.

We checked these areas as part of this focussed inspection and found the service had taken prompt action to put in place effective processes to address the areas identified for improvement during the previous inspection.