This practice is rated as Requires Improvement overall. (Previous rating February 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Chineham Medical Practice on 21 June 2018 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.
• Several mandatory training modules were not up to date for some members of staff.
• 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.
• Patient outcomes data was below local and national average in some areas. For example, Quality and Outcome Framework (QOF) data had not been fully addressed with regards to clinical indicators for diabetes and mental health outcomes.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it for urgent reasons.
• The practice scored higher than local and national averages in the National GP Survey for treating their patients with kindness and compassion.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• Staff had been supported to develop their professional skills and remained at the practice in their new roles which benefited the patient population.

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

• 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 care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Review arrangements for identifying and registering patients who are also carers.

• Review practice policies to ensure all contain up to date information and feature an appropriate review date.
• Continue to review patient feedback regarding access to appointments and the experience of making appointments.
• Review how Quality and Outcome Framework (QOF) data is monitored to improve clinical indicators in diabetes, mental health and uptake of cervical screening.
  

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.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chineham Medical Practice on 17 February 2015. Overall the practice is rated as good.

We found the practice to be good for providing safe, caring, effective, responsive and well led services.

It was also good for providing services for older people, people with long term conditions, working age and recently retired people, families, children and young people, people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Learning from incidents was not consistently shared with relevant staff members.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks, fire safety and portable electrical appliance testing.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff considered they had received training appropriate to their roles and any further training needs had been identified and planned for.
• 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.
• The practice had a number of policies and procedures to govern activity; these were in the process of being reviewed by the practice manager.
• Focus groups for particular population groups were held and included the use of online surveys where patients could respond to questions anonymously if they chose to.
• The registered manager was unfamiliar with the legal responsibilities of being a registered person.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice