This practice is rated as Requires Improvement overall.

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

We carried out an announced comprehensive inspection at Grainger Medical Group on 31 July 2018. This was as part of our inspection programme; to inspect all practices within 12 months of a new registration with the Care Quality Commission.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. However, systems, processes and practice were not always reliable or appropriate to keep people safe. Monitoring of whether safety systems were implemented was not always effective. When incidents did happen, the practice learned from them and improved their processes.
• Clinicians assessed and delivered care and treatment in line with current legislation, standards and guidance supported by clear clinical pathways and protocols.
• The practice had started to review the effectiveness and appropriateness of the care they provided. However, this work had yet to demonstrate improvements were made as a result.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice understood the needs of its population and had taken steps to tailor services in response to those needs.
• Patients were not always able to access care and treatment from the practice within an acceptable timescale for their needs. There were low satisfaction levels with access to the practice by phone and experience of making an appointment.

• There was some evidence of systems and processes for learning, continuous improvement and innovation. The practice was in the process of developing a clinical leadership structure to support a stronger focus on continuous innovation and improvement.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

The areas where the provider should make improvements are:

• Review the decision to not stock medicines to treat patients experiencing bradycardia (a slower than normal heart rate) during minor surgery or fitting of contraceptive coils.

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.