Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at East Park Medical Centre – R P Pandya on 24 May 2016. The overall rating for the practice was good and the practice was rated as requires improvement for the safe domain. The full comprehensive report on the May 2016 inspection can be found by selecting the ‘all reports’ link for East Park Medical Centre – R P Pandya on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 19 January 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 24 May 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 practice was tidy, visibly clean and all single use items were in date.

• A locum recruitment policy had been implemented and all appropriate pre-employment checks were carried out for locum GPs and locum nurses.

• A legionella risk assessment for both sites was carried out which identified areas for improvement. The practice had carried out most of the work in relation to the recommendations.

• A fire alarm service inspection and emergency lighting inspection had been carried out and the practice had completed work that required attention.

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 East Park Medical Centre on 24 May 2016. Overall the practice is rated as good.

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

• There was an effective system in place to report and record significant events. They were investigated, discussed at staff meetings and lessons were shared to improve safety in the practice.

• Not all appropriate recruitment checks were carried out on locum GPs and there was no policy in place to ensure appropriate checks were gathered before employment of locum staff.

• There were procedures in place for monitoring and managing risks to patient and staff safety. However, some risk assessments had not been reviewed and not all actions identified as a result of a risk assessment had been carried out.

• The practice was tidy and mostly visibly clean.

• Staff assessed needs and delivered care in line with current evidence based guidance.

• The practice used locally implemented prescribing guidelines, which followed best practice.

• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs. GPs carried out weekly visits to the two residential homes, where some of their patients resided.

• Patient feedback said staff were polite, caring and understanding.Patients said they were given enough time during appointments and they felt listended to.

• The practice were culturally sensitive and aware of the needs of the local population.

• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Information about how to complain was available and easy to understand. The practice responded in a timely manner to issues raised and learning from complaints was shared with staff.

• The practice had a strategy to sustain achievements against the quality and outcome framework, as well as to continue holistic care to patients. Staff were aware of the practice strategy and aim to provide holistic care to patients.

• There was a leadership structure and staff felt supported by management. Staff told us there was mutual respect within the practice between all staff members.

• The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.

• The patient participation group was active and involved in improving patient education.

The areas where the provider must make improvement are:

• Ensure all risk assessments are reviewed as appropriate and actions are taken to mitigate identified risk.

• Ensure all areas of the practice are appropriately cleaned and single use stock is checked accordingly.

• Ensure appropriate checks are carried out before the employment of locum staff.

The areas where the provider should make improvement are:

• Ensure policies are reviewed as appropriate and action is taken in accordance with practice policies.

• Consider the implementation of a practice policy to support the process to recruit locum staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with six patients, three GPs, the nurse practitioner, four reception staff and the practice manager during our visit of the main and branch surgeries. Patients told us they were satisfied with the care and treatment they received, however were displeased with the delays in getting appointments and with some GP surgeries running late.

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. Comments about the service included that it was a “Very good surgery” and the person was pleased “The receptionist spoke my language.” Another person said they were “Very pleased” with their doctor and they “Felt that they were well treated.”

We felt some staff needed further training in safeguarding children and vulnerable adults.

Certain items of emergency equipment were missing so the practices could not ensure peoples’ safety in an emergency situation.

The provider needed to provide better systems in place for recruiting staff and monitoring the quality of service provision.

We felt the building provided good access for patients with mobility problems. Medicines and vaccines are stored appropriately.