This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Leicester City, Leicestershire and Rutland Out-of-Hours Service on 20 and 21 December 2018 and 9 January 2019 as part of our inspection program. The service had not been previously inspected.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• Some staff we spoke with said that were reticent to raise concerns for fear of repercussions.
• They also told us that the staffing levels in the home visiting and night nursing service did not always ensure that patients got seen in a timely manner.
• 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.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients could access the out-of-hours service within an appropriate timescale for their needs.
• The service took patient feedback and experiences seriously, and had an effective system and process to gather patient views and act upon them where necessary.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The provider should;

• Review their systems to assure themselves that where sessional GPs used their own equipment, it was safe and appropriate.
• Review the infection prevention and control measures at Leicester Royal Infirmary.
• Review their process to ensure prescription security across all sites.
• Review the process to encourage staff to raise concerns and to feedback on the concerns raised.
• Review the on-call manager system to provide assurance to staff.
• Continue to review staffing levels of the home visiting service and night nursing service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care