Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Adelaide Medical Centre, Adelaide Road, Andover, Hampshire, SP10 1HA on 19 July 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

Review arrangements for identifying patients who are carers and demonstrate how the practice supports them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our previous inspection in December 2013 we found the provider was not ensuring people's safety and welfare because regular checks of emergency medical equipment had not taken place. We also found the provider did not have effective measures in place to ensure the safe storage of medicines. The provider had also not carried out clinical audits.

The provider told us they would make improvements.

During this inspection, we found the provider had made all the improvements they said they would. For example, we saw records of regular checks of emergency equipment had been carried out.

The provider had introduced a policy for the safe storage and return of medicines. The staff we spoke with were aware of the policy that had been introduced. We found the fridges and cupboards that stored medicines were locked when not in use and there was a secure key holder to hold the keys. This meant that access was restricted to those authorised and prevented the loss of keys.

The provider had carried out clinical audits, reported and investigated any significant events and written a business continuity plan. This plan would ensure continued running of the service in the event of a major incident.

People who use the service were given appropriate information and support regarding their care or treatment. People told us that the doctors took time to explain things to them. One person told us the doctor had used a model to support their understanding of the way their illness affected them.

We saw there were a variety of information leaflets available to people both in the reception and around the practice. One member of staff told us; "I have a good relationship with most patients, patient care is of utmost importance." One patient told us; "I know all the staff, they always make you feel very welcome. I have absolutely no concerns about the practice at all. It is clean, tidy and everyone is very friendly".

There were arrangements in place to deal with foreseeable emergencies however we found that emergency equipment was not always checked. We looked at the practice defibrillator that formed part of the emergency equipment and found that the automated external defibrillator (AED) pads had expired in September 2013. For an AED to provide the right kind of therapy to a sudden cardiac arrest (SCA) victim, the AED pads must make proper contact with the patient’s skin.

We saw there were systems in place to ensure that regularly used vaccines were stored in one of two lockable fridges at the correct temperature. However we only saw evidence that demonstrated that temperatures were recorded daily for one of the fridges. The practice manager assured us that medications were not kept in GP consultation rooms, however in three of the five rooms we checked we found packets of returned medicine. These packets of returned medications were found in unlocked cupboards in unlocked consulting rooms.

We spoke with seven patients during our visit. They were very happy with the care and services provided. One patient told us: “I’ve got no issues. If I felt there was room for improvement I’d go somewhere else”.

We asked the practice manager how the practice assessed and monitored the quality of its services. There was no evidence of any monitoring being carried out. The practice manager told us that other than participating in the Quality and Outcomes Framework (QOF) they did not assess and monitor the quality of the service. The practice manager told us that clinical audits, assessments or monitoring had not been carried out to identify or manage risk within the practice for staff or equipment. There was no risk assessment to safeguard the health and safety of patient’s.