This practice is rated as Requires Improvement overall.

We previously carried out an announced comprehensive inspection at Dawley Medical Practice in July 2015. The practice was rated as good overall. The full comprehensive report on the July 2015 inspection can be found by selecting the ‘all reports’ link for Dawley Medical Practice on our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection at Dawley Medical Practice on 15 October 2018 as part of our inspection programme.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Requires Improvement

At this inspection we found:

• The practice had systems, processes and practices in place to protect people from potential abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads and contacts for external safeguarding agencies. Clinical staff had received training to the appropriate level for their role but not all reception and administrative staff had received training in safeguarding children.
• The practice had systems to manage most risks so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• Systems in place for identifying, assessing and mitigating most risks to the health and safety of patients and staff were not effective. For example, the system for monitoring of patients on high risk medicines was not effective. The practice did not have a system to assure that appropriate action had been taken in response to patient safety alerts such as the Medicines and Healthcare Products Regulatory Agency (MHRA).
• Staff recruitment practices were in line with legal requirements, however an assessment of mental and physical health including immunity status of staff had not been recorded.
• The practice had reviewed the appointment system in response to patient feedback. However, further work was needed to improve patient satisfaction in relation to access to appointments.
• The practice had installed a new telephone system to better manage patient calls.
• The practice had an active patient participation group.
• There was a focus on continuous learning and improvement. However, there was a lack of oversight in ensuring staff had completed basic training. There were significant gaps noted in staff training records and at the time of the inspection, there was a lack of protected time given to complete training.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure specified information is available regarding each person employed.

The areas where the provider should make improvements are:

• Formulate an action plan for responding to the results of the GP patient survey to include actions to address the lower than average results regarding access to the service.
• Offer more opportunities for clinical supervision and protected learning time to complete basic training.

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 Dawley Medical Practice on 2 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services for the following population groups; older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings 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.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• 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 that although they had to wait they found it easy to make an appointment with a named GP and that there was continuity of care, with 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.

There were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Continue to review recruitment procedures to ensure that all staff who are involved in the direct care of patients such as providing treatment or chaperone duties are risk assessed to determine if a Disclosure and Barring Service (DBS) check is required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice