We carried out a focussed, desk based inspection at JDoc Medical - Wellington Diagnostic Centre on 13 December 2018. We found the service was providing well-led care in accordance with the relevant regulations.

We had previously conducted an announced, comprehensive inspection of the service on 16 August 2018 at which time we found the care being provided was safe, caring, effective and responsive but that it was not being provided in accordance with the relevant regulations relating to well led care. We found the provider had breached Regulation 17 (1) (Good governance) of the Health and Social Care Act 2008 due to governance arrangements not always working effectively. The service wrote to us to tell us what they would do to make improvements and meet the legal requirements.

We undertook this focussed, desk based follow up inspection to check the service had followed their plan and to confirm they had met the legal requirements.

This report only covers our findings in relation to those areas where requirements had not been met. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for JDoc Medical - Wellington Diagnostic Centre on our website at www.cqc.org.uk/location/1-1697990494.

Our key findings across all the areas we inspected were as follows:

• The service had acted to ensure that effective governance systems and processes were in place, clearly set out and understood.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 16 August 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 care 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 not providing well-led care in accordance with the relevant regulations.

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.

JDoc Medical - Wellington Diagnostic Centre provides private general practitioner consultation and treatment services.

Two people provided feedback about the service – both of whom were entirely positive.

Our key findings were:

• Governance arrangements did not always operate effectively. For example, although staff safely managed medicines, the written protocols governing this activity were either out of date, not specific to the service or not in place. The service also lacked a written patient safety alert protocol and governance arrangements had failed to identify lapsed staff training.
• There was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Clinical audit was being used to drive improvements in patient outcomes.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients.
• The service’s lead GP is the registered manager. 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.

We identified regulations that were not being met and the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.

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

• Review protocols for ensuring that regular adult antibiotic prescribing audits take place.
• Review protocols to ensure that there is a formal protocol in place for checking patient test results.
• Review protocols for ensuring that staff teams receive sepsis training.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice