Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 5 March 2015. Breaches of legal requirements were found in relation to the recruitment of staff and the recording, analysis, and sharing of learning from significant events. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements. We undertook this focused inspection on 4 May 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

Our previous report highlighted the following areas where the practice must improve:-

• Ensure that all staff recruitment files contain relevant information as required under the regulation, including criminal records checks via the Disclosure and Barring Service for those staff who undertake chaperone duties.

• Ensure that all significant events are recorded and that there is a greater degree of learning, including reviewing the impact upon the service provided to ensure that the event is not repeated.

Our previous report also highlighted the following areas where the practice should improve:-

• Ensure that when needed language line is considered to help patients.

• Ensure required codes for risks to children and young people on child protection plans are shown as active or non-active.

• Ensure that annual appraisals record appropriate information and that staff are given a copy of their objectives.

• Ensure that staff inductions are role related and that sign off on specific learning is recorded.

Our key findings across the areas we inspected for this focused inspection were as follows:-

• There was an open and transparent approach to safety and an effective system in place for reporting, recording, and learning from significant events.
• The practice had appointed a new lead nurse to provide additional leadership for the nursing team.
• The practice had undertaken appropriate recruitment checks prior to the employment of staff. They also regularly checked registration status with the appropriate professional body.
• Staff had recently been provided with a new e-learning system, and this had been opened out to include locums who worked at the practice.
• There was evidence of appraisals and induction plans for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bewbush Medical Practice on 5 March 2015. Overall the practice is rated as good.

Bewbush Medical Practice provides services to people living in the Bewbush, Crawley area. At the time of our inspection there were approximately 7,400 patients registered at the practice with a team of two GP partners. The practice was also supported by locum GPs, nurses, healthcare assistants and a team of reception and administrative staff.

We visited the practice location at Bewbush Medical Practice, Bewbush place, Bewbush, Crawley, RH11 8XT

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. There was a culture of openness and transparency within the practice and staff told us they felt supported. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

Our key findings were as follows:

• Staff understood their responsibilities to raise concerns, and to report incidents and near misses.
• Information about safety was recorded, monitored, reviewed and addressed.

• Risks to patients were assessed and well managed
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment and 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

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that all staff recruitment files contain relevant information as required under the regulation, including criminal record checks via the Disclosure and Barring Service for those staff who undertake chaperone duties.
• Ensure that all significant events are recorded and that there is a greater degree of learning, including reviewing the impact upon the service provided to ensure that the event is not repeated.

In addition the provider should:

• Ensure that when needed language line is considered to help patients
• Ensure required codes for risks to children and young people on child protection plans are shown as active or non-active
• Ensure that annual appraisals record appropriate information and that staff are given a copy of their objectives.
• Ensure that staff inductions are role related and that sign off on specific learning is recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating 4 June 2016 – Good)

The key questions at this inspection 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 Location name on Bewbush Medical centre as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice 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 patients with compassion, kindness, dignity and respect.
• Patients found the appointment system generally easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Introduce a tracking system to monitoring computer prescription paper sent to the consultation rooms.
• Develop a protocol and training in sepsis for the staff team.
• Take action to record all complaint review discussions are minuted at practice meetings.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.