Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingsfold Medical Centre on 12 September 2016. The overall rating for the practice was good with the key question of safe rated as requires improvement. The full comprehensive report on the September 2016 inspection can be found by on our website at http://www.cqc.org.uk/location/1-538845510

This inspection was a desk-based review carried out on 16 March 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 12 September 2016. This report covers our findings in relation to those requirements.

Overall the practice is now rated as good.

Our key findings were as follows:

• At the inspection in September 2016 we found that appropriate checks through the Disclosure and Barring Service (DBS) were not always carried out for some staff. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). The recruitment policy did not include the importance of undertaking a DBS check and required updating. At this desk-based review we saw evidence that the practice had carried out all necessary DBS checks and had revised the recruitment policy to include DBS checks for staff.
• At our previous inspection, we identified that the surgery did not review actions taken as a result of significant events in the practice. For this inspection, the practice provided evidence to show that a new significant event protocol had been developed and adopted by the practice in order to address this.
• At our inspection in September 2016, we found that although an infection control audit had been undertaken by the practice, there was no action plan to address the findings of the audit. At this desk-based review, we saw that a further audit had taken place, an action plan had been recorded and that work was underway to address those areas identified by the audit.
• At our previous inspection, we found that not all clinical staff had the necessary I.T. skills needed to access the practice policies and procedures. For this review, the practice provided evidence in the form of a staff signature sheet that showed that all staff were able to access the practice policies and procedures.
• During the inspection in September 2016, we noted that there was no information easily available to patients in the waiting area regarding the use of chaperones or information about the practice complaints procedure. For this inspection, the practice sent us a chaperone poster and a complaints poster which they told us were now displayed in the patient waiting area. The practice also supplied a patient complaints leaflet which was available in the reception area.
• At our inspection in September, we found that there was no formal mechanism for sharing and reviewing safety alerts and monitoring that actions were carried out. At this inspection, the practice supplied us with a new protocol for the management of patient safety alerts which we were told the practice had adopted.
• At our previous inspection, we found that some equipment maintenance had not taken place following electrical safety testing. The practice sent us evidence of further equipment testing and calibration carried out in February 2017 and evidence of up to date electrical testing that showed all equipment was safe to use.
• At the inspection in September 2016 we found that the practice did not have paediatric defibrillator pads available for the resuscitation of children in an emergency. For this inspection, the practice sent us proof of purchase of these pads.

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 Kingsfold Medical Centre, Woodcroft Close Penwortham, Preston Lancs, PR1 9BX on 12th September 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 however there was no formal system to discuss and learn from these events.

• Generally risks to patients were assessed and well managed however we noted that recommended electrical maintenance had not been carried out.
• 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 the services provided 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 found it easy to make an appointment with a 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 improvements:

The practice recruitment policy must be updated to reflect the practice has undertaken the required recruitment checks, including for example Disclosure and Barring Service (DBS) and identify checks, particularly for clinical staff.

The areas where the provider should make improvements :

• Improve the recording of significant incidents so that actions taken can be reviewed and shared
• Complete the actions identified in the practice’s infection prevention and control audit
• .All staff should have the I.T. skills required to access policies and procedures on the practice computer system.
• Posters providing information on the complaints process and the availability of chaperones should be visible in the patient waiting area.
• The practice should consider a more formal mechanism to share and review safety alerts, serious events and complaints and monitor that required actions are carried out.
• Continue to undertake regular electrical testing and maintence of equipment within the practice

• Obtain a set of paediatric defibrillator pads for use with children

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Kingsfold Medical Centre on 8 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.