Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Donnington Medical Partnership on 23 November 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to make an appointment with a named GP and 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Ensure the safe management of medicines, including blank prescription security, the adequate checking of medicines stored at the premises.

• Staff must follow the correct procedure regarding the administration of vaccines and medicines against a patient specific prescription or direction from a prescriber.

• Ensure that all medical equipment is calibrated on an annual basis, including the practice’s defibrillator.

• Ensure that all staff have child safeguarding training relevant to their role.

The areas where the provider should make improvement are:

• Ensure the appropriate provision of timely home assessments for housebound patients with a respiratory disease.

• Ensure the appropriate identification of patients with a learning disability and the provision of annual health checks and health action plans.

• Encourage the uptake of the cervical screening programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

At our previous comprehensive inspection at Donnington Medical Partnership on 23 November 2016 we found breaches of regulation relating to the safe care and treatment. The overall rating for the practice was good but we found the practice to require improvement for the provision of safe services. It was good for providing, effective, caring, responsive and well-led services. Consequently we rated all population groups as good. The previous inspection reports can be found by selecting the ‘all reports’ link for Donnington Medical Partnership on our website at www.cqc.org.uk.

This inspection was an announced desktop inspection carried out on 31 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 23 November 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made the required improvements since our last inspection and was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the practice is rated as good.

Our key findings were as follows:

• Improvements had been made to medicines management processes and the administration of medicines which required authorisation from prescribers.
• The system of monitoring training had been improved to ensure when staff needed safeguarding training it was delivered.
• Calibration checks on emergency equipment was undertaken when required.

In addition to the areas we told the provider to make improvements we also asked the provider to consider making improvements in other areas. The practice had taken action as a result:

• The practice had identified 20 patients who required home visits for reviews of their long term conditions and the practice was in the process of enabling nurses to provide these.

• A new recall letter had been created and was being sent to encourage women eligible for cervical smears to undertake these. The uptake of smears had increased from 70% in 2016 to 77% in 2017.
• The practice had identified 58 patients with learning disabilities and was in the process of contacting these patients to request them to undertake health checks and reviews. At the time of inspection only five of these patients had received health checks. In July 2017 the practice had extended the role of their practice care navigator to include patients with learning disabilities to enable visits and additional prompting for health checks.

Areas the provider should make improvements

• Increase the uptake of learning disability reviews to ensure that this group of patients receive the assessments that reduce the risk unidentified or exacerbations related to existing health problems.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice