Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Failsworth Group Practice on 9 August 2016. Overall the practice is rated as good.

The practice had been previously inspected on 8 December 2015. Following this inspection the practice was rated inadequate with the following domain ratings:

Safe – Inadequate

Effective – Requires improvement

Caring – Requires improvement

Responsive – Inadequate

Well-led – Inadequate

The practice was placed in special measures.

Following this re-inspection on 9 August 2016 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.
• Risks to patients were assessed and well managed, with the exception of some recruitment procedures.
• 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 usually found it easy 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 area where the provider must make improvement are:

• The provider must ensure all relevant pre-employment procedures are carried out for staff, including locum clinicians.

The areas where the provider should make improvements are:

• The provider should share the findings of audits with all appropriate staff in the practice to ensure relevant learning is carried out.

• The provider should check that all clinicians are aware of how significant events should be recorded.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

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 Failsworth Group Practice on 8 December 2015. Overall the practice is rated as inadequate.

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment.

• Staff were not clear about reporting incidents, near misses and concerns and there was no guidance available for them to follow.

• Clinically, patient outcomes were identified and there was reference made in audits to quality.

• Patients were unclear how to complain and information was not easily available. The complaints’ policy did not contain all the required information.

• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.

• Appointment systems were not working well so patients did not receive timely care when they needed it.

• There was insufficient leadership capacity and limited formal governance arrangements.

The areas where the provider must make improvements are:

• Ensure the safeguarding policy contains up to date information to guide staff. Ensure all staff are aware of who the practice leads are for safeguarding. Ensure all staff have received appropriate safeguarding training.

• Ensure the complaints’ policy includes the required information and patients are able to easily find out how to make a complaint. To also ensure complaints’ responses are in line with current legislation.

• Ensure there are policies and procedures in place to guide staff and ensure effective governance systems. To use the views of patients to improve aspects of the service. To put systems in place so when quality and safety is compromised this is recognised. To ensure appointment availability is monitored appropriately so access issues are identified.

• Ensure all staff receive appropriate training on induction, and effective training at the required intervals. To ensure the practice manager is supervised.

• Ensure recruitment arrangements include all necessary employment checks for all staff.

The areas where the provider should make improvement are:

• Give guidance to staff so they understand what a significant event is so all appropriate events are correctly recorded and actioned.
• Improve the infection control policy so more guidance is available.
• Bring the mission statement to the attention of all staff.
• Put in place a remit for the patient participation group and liaise with them in order for them to feel the practice is receptive to their ideas.

I am placing this practice in special measures. Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The practice will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration. Special measures will give people who use the practice the reassurance that the care they get should improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We first carried out an announced comprehensive inspection at Failsworth Group Practice on 8 December 2015. Following this inspection the practice was rated inadequate and placed in special measures.

We carried out a further full comprehensive inspection on 9 August 2016 to check the required improvements had taken place. Overall the practice was rated as good following the August 2016 inspection. The domain of safe was rated as requires improvement as improvement was required regarding recruitment procedures. The previous inspection reports can be found by accessing the ‘all reports’ link for Failsworth Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 20 March 2018. This inspection was to check the areas where the provider must or should make improvements had been actioned. At this inspection we found:

• All the required checks were carried out prior to new staff being employed.

• Clinical audits were discussed with all appropriate staff in meetings. A summary of audits including actions that were required was also kept.

• The process for recording significant events had been reviewed and all staff had attended a workshop to discuss the process.

The practice is now rated good in the safe domain.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice