Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cockfosters Medical Centre on 23 August 2016. The overall rating for the practice was good, however there was a breach of regulation identified which resulted in the rating of requires improvement for the effective domain. The full comprehensive report for the inspection carried out in August 2016 can be found by selecting the ‘all reports’ link for Cockfosters Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 10 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 23 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good, including the effective domain.

Our key findings were as follows:

• The practice had a failsafe system in place for the monitoring of screening results, a GP partner was the lead for the system. One sample taker had completed refresher training and the other sample taker was booked to attend training in June 2017.

• The practice adheres to a carer protocol and has increased the number of carers identified to more than 1% since the inspection in August 2016.

• The practice has created a prescription pad security protocol and maintains a register of serial numbers for all prescriptions received and distributed.

• The practice has taken steps to improve patient satisfaction including securing a grant to update the premises. For example, the addition of an automatic door which has received positive feedback from patients.

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

In addition the provider should:

• Continue to monitor the rate of screening samples unsuitable for analysis by the lab and ensure this percentage is in line with or below the national average of 2.5%.

At our previous inspection on 23 August 2016, we rated the practice as requires improvement for providing effective services as the system for monitoring the results of screening samples did not include investigation, learning and outcomes when there is a high percentage of samples being identified as unsuitable for analysis by the laboratory. At this inspection we found that a system monitoring the quality of screening samples had been introduced and a significant improvement had been made in reducing the number of screening samples that are unsuitable for analysis.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Patients we spoke with told us they felt able to openly discuss the reason for their visit with the GP or nurse and that they were given sufficient information on any treatment required. One patient told us "I got all the advice from the doctor I needed." Patients on the whole felt they understood their doctor or nurse and felt listened to and supported.

Patients expressed their views and were involved in making decisions about their care and treatment. A patient participation forum was in place and a recent survey looked at access to appointments and changes were made. All the patients we spoke with were positive about the appointments system. One patient told us “I get an appointment same day, it’s great.”

A patient described the service as "very friendly and caring". Patients’ needs were assessed and care and treatment planned and delivered in line with their individual plan of care. Processes were in place to ensure the timely review of patients with long-term conditions at specified intervals.

Patients were protected from the risk of abuse. Staff understood their responsibilities to act when they suspected a child or a vulnerable adult were at risk.

All patients we spoke to commented that the practice was clean. Guidance had been followed in relation to infection control.

Patients were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cockfosters Medical Centre on 23 August 2016. The overall rating for the practice was good, however there was a breach of regulation identified which resulted in the rating of requires improvement for the effective domain. The full comprehensive report for the inspection carried out in August 2016 can be found by selecting the ‘all reports’ link for Cockfosters Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 10 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 23 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good, including the effective domain.

Our key findings were as follows:

• The practice had a failsafe system in place for the monitoring of screening results, a GP partner was the lead for the system. One sample taker had completed refresher training and the other sample taker was booked to attend training in June 2017.

• The practice adheres to a carer protocol and has increased the number of carers identified to more than 1% since the inspection in August 2016.

• The practice has created a prescription pad security protocol and maintains a register of serial numbers for all prescriptions received and distributed.

• The practice has taken steps to improve patient satisfaction including securing a grant to update the premises. For example, the addition of an automatic door which has received positive feedback from patients.

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

In addition the provider should:

• Continue to monitor the rate of screening samples unsuitable for analysis by the lab and ensure this percentage is in line with or below the national average of 2.5%.

At our previous inspection on 23 August 2016, we rated the practice as requires improvement for providing effective services as the system for monitoring the results of screening samples did not include investigation, learning and outcomes when there is a high percentage of samples being identified as unsuitable for analysis by the laboratory. At this inspection we found that a system monitoring the quality of screening samples had been introduced and a significant improvement had been made in reducing the number of screening samples that are unsuitable for analysis.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice