Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crawley Road Medical Centre on 24 November 2016. The practice was rated requires improvement for safe and well-led services which resulted in an overall rating of requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Crawley Road Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 July 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 during our previous inspection on 24 November 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.

Our key findings were as follows:

• The lead for infection prevention and control at the practice was up to date with infection control training.

• The practice provided evidence that they had made improvements to the premises in line with the infection control audit action plan.

• There were systems in place for the safe management of medicines.

• There were policies in place for managing significant events and uncollected prescriptions.

• Portable electrical testing (PAT) was completed for all electrical items at the practice.

• There was a portable oxygen cylinder available at the practice.

• There was a system in place for monitoring the use of blank prescription pads.

• All staff at the practice had completed information governance training.

• There was a comprehensive system in place for pre-travel vaccination assessments.

However, there was an area of practice where the provider needs to make improvements.

The provider should:

• Signpost the electrical outlets for both pharmaceutical fridges to reduce the risk of accidental disconnection from the power source.

At our previous inspection on 24 November 2016, we rated the practice as requires improvement for providing safe and well-led services as we found there were gaps in governance arrangements for managing medicines and infection prevention and control training for the infection control lead at the practice. At this inspection we found that the practice had improved systems for managing medicines. We found that the lead for infection control was up to date with infection control training. Consequently, the practice rating has improved to good for safe and well-led services resulting in an overall rating of good.

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 Crawley Road Medical Centre on 24 November 2016. The practice was rated requires improvement for safe and well-led services which resulted in an overall rating of requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Crawley Road Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 July 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 during our previous inspection on 24 November 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.

Our key findings were as follows:

• The lead for infection prevention and control at the practice was up to date with infection control training.

• The practice provided evidence that they had made improvements to the premises in line with the infection control audit action plan.

• There were systems in place for the safe management of medicines.

• There were policies in place for managing significant events and uncollected prescriptions.

• Portable electrical testing (PAT) was completed for all electrical items at the practice.

• There was a portable oxygen cylinder available at the practice.

• There was a system in place for monitoring the use of blank prescription pads.

• All staff at the practice had completed information governance training.

• There was a comprehensive system in place for pre-travel vaccination assessments.

However, there was an area of practice where the provider needs to make improvements.

The provider should:

• Signpost the electrical outlets for both pharmaceutical fridges to reduce the risk of accidental disconnection from the power source.

At our previous inspection on 24 November 2016, we rated the practice as requires improvement for providing safe and well-led services as we found there were gaps in governance arrangements for managing medicines and infection prevention and control training for the infection control lead at the practice. At this inspection we found that the practice had improved systems for managing medicines. We found that the lead for infection control was up to date with infection control training. Consequently, the practice rating has improved to good for safe and well-led services resulting in an overall rating of good.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We did not speak to people using the service as part of this inspection because of the nature of the compliance actions we were following up.

At our previous visit on 28 April 2014, the provider had taken some steps to provide care in an environment that was more suitably designed, but there were shortfalls in terms of the maintenance of the premises and there was no clear and detailed plan to say what work was required and when the work would be completed.

At our inspection on 11 September 2014, we found that most of the maintenance work including hot water in the consulting rooms, repair to tiles and cracks in the ceiling, replacing floors, treatment of damp and painting of walls had been completed. There were plans in place to complete minor finishing touches such as ceiling light covers by October 2014

At our last inspection on 11 December 2013 we found the provider had not taken reasonable steps to ensure that medicines were kept safely. The provider had not taken steps to provide care in an environment that was suitably designed and adequately maintained and records were not kept securely.

At our inspection on 28th April 2014 we found the provider had taken reasonable steps to ensure that medicines and records were being kept safely. They were meeting these essential standards.

The provider had taken some steps to provide care in an environment that was more suitably designed, but there were shortfalls in terms of the maintenance of the premises and there was no clear and detailed plan to say what work was required and when the work would be completed.

We did not speak to people using the service as part of this inspection because of the nature of the compliance actions we were following up.

People we spoke with told us they were involved in making decisions about their care and treatment. People said, “they put themselves out to respect your wishes” and “they ask whether I would like to try X.” There was evidence that the practice accommodated people's needs with respect to religion, culture and disability.

People told us they were satisfied with the quality of the treatment. One person said, "it's been fantastic from day one." We found people's treatment reflected relevant research and guidance, including extra specialised training for staff.

We found evidence that the provider worked in cooperation with other providers, including regular information sharing meetings.

We found that people who use the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises. There were not adequate arrangements in place with regard to fire safety and maintenance. Some medicines were not appropriately stored.

People told us that the provider was not always able to cover doctors' absences but we did not find that this affected people's care. We saw evidence that staff had skills and experience relevant to their roles.

We found the service had a complaints system and policy and that the provider had followed this when responding to complaints.

We found there were suitable arrangements in place for the storage of records, but some were not securely stored.