Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Cranleigh Gardens Medical Centre on 18 November 2014. The provider has a branch surgery in Westonzoyland, Somerset but we did not inspect this as part of our inspection.

Overall we judged this service as good.

Our key findings were as follows:

• Routine appointments could usually be fitted in within a week. If a patient requested they were given a same-day triage call.
• Patient’s needs were assessed and care was provided accordingly.

• There were systems in place to ensure the safety of patients, staff and visitors to the practice.

• The patient participation group (PPG) actively engaged with patients to seek feedback and acted as “eyes and ears” for the practice management. Where changes were made to the operation of the practice the PPG acted as intermediary to provide patients’ views.

• The practice manager and deputy manager had an open door policy and staff told us they were approachable. Staff said they could go to the practice manager, deputy, their team leader or any of the GPs for support if needed.

We saw several areas of outstanding practice including:

• For patients with long term conditions the practice had developed a ‘patient passport’. The practice leaflet explained the ‘passport’ was a small booklet that patients took to appointments to help with the booking of follow-up appointments. The aim of the passport was to help direct the patient by recording when they needed to be seen, by whom and for what purpose. This ensured patients were seen in a timely way.

• As part of succession planning the practice was engaging with the Equality and Diversity Forum so that it would be able to meet the needs of any population group growth.

• There was a men’s health event provided by the practice. Men were invited to the event to enable them to gain specific information relating to men’s health issues.

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

The provider should:

• The provider should ensure the start date for the use of sharps bins is recorded.

• In order to protect staff and patients GPs should not leave medicines on desks, unsecured.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating December 2018 – Good overall with requires improvement for safe).

The key question at this inspection is rated as:

Are services safe? – Good

We carried out an announced focused inspection at Cranleigh Gardens Medical Centre on 10 April 2019 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in Regulation 13 HSCA (RA) Regulations 2014: Safeguarding service users from abuse and improper treatment. We had identified systems and processes should be implemented to provide staff with safeguarding training necessary for their role including vulnerable adults at risk of abuse and Prevent. We found the concerns had been resolved when we undertook a follow up inspection of the service on 10 April 2019.

During this inspection we reviewed areas where the provider should make improvements identified in our previous inspection (5 December 2018) and our key lines of enquiry for ‘Safe’. This report and supporting Evidence Table covers our findings in relation to these.

The full comprehensive report on the December 2018 inspection can be found by selecting the ‘all reports’ link for Cranleigh Gardens Medical Centre on our website at www.cqc.org.uk

At this inspection we found:

• The practice had clear systems, processes and practices to protect people at risk of or suffering from abuse or neglect.
• Staff have the necessary skills and competencies appropriate for their role to identify and raise safeguarding concerns.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. We found the practice’s necessary and statutory training for staff was in line with or above national guidance.
• Arrangements were in place to support and manage staff to deliver effective care and treatment such as clinical supervision for nurses and annual appraisal system for salaried GPs.
• The practice had taken action to improve cervical screening uptake rates and identify the number of patients with carer responsibilities.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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