This service is rated as Requires Improvement overall. This service has not been previously inspected

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? –Requires Improvement

We carried out an announced comprehensive inspection at Gloucester Out of Hours on 3, 4 and 5 September 2018 as part of our inspection programme and regulatory functions under Section 60 of the Health and Social Care Act 2008.

At this inspection we found:

• The service had systems to manage risk so that safety incidents were less likely to happen. For example, there were systems to fill any gaps in the rota to ensure appropriate clinical cover at all sites. When safety incidents did happen, the service learned from them and made efforts to improve their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• The service was not consistently meeting performance targets; however, a detailed and measurable recovery plan was in place to address these areas.
• Staff involved and treated people with compassion, kindness, dignity and respect. Feedback from patients for all aspects of care was positive.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• There had been significant recent management changes which had impacted upon the operating of effective governance processes. For example, staff training and appraisals.
• Leaders were not visible and not all staff felt supported, respected and valued.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice