Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Monkwearmouth Health Centre on 3 September 2015, which resulted in the practice being rated as good overall but as requiring improvement for providing safe services. The full comprehensive report can be found by selecting the ‘all reports’ link for Monkwearmouth Health Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out in December 2016 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection in September 2015. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is rated as good overall; including for providing safe services.

Our key findings were as follows:

• Pre-employment checks had been carried out for new staff.
• Staff had received appropriate chaperone and infection control training.
• Sharps boxes were appropriately labelled and fire extinguishers were serviced within designated timescales.
• Infection control audits were carried out regularly. The practice manager had arranged to accompany the domestic supervisor on a quarterly inspection of cleaning standards. One inspection had been carried out in October 2015; due to other commitments the practice manager had not attended the following three inspections but had arranged to attend in early December 2016.
• All staff had received an annual appraisal.
• A business plan had been drafted and was awaiting final approval from the GP partners.

The area where the provider should make improvements is:

• Take steps to ensure quarterly inspections of cleaning standards are carried out.

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 Drs Gellia and Balaraman on 3 September 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing caring, effective, responsive and well-led services. It was also good for providing services for the following population groups: People with long-term conditions; Families, children and young people; Working age people; People experiencing poor mental health (including people with dementia); people whose services may make them vulnerable. We found the practice required improvement for providing safe services.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients, staff and visitors to the practice were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles; however, not all staff had received infection control training.
• Not all staff who carried out chaperone duties had received appropriate training
• 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.
• The majority of patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available on the same day.
• The practice offered extended opening hours commencing at 7.30am and up to 7:00pm one day per week which improved access for patients who worked full time.
• 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.
• In general, the practice did not have any process in place to monitor services supplied by the landlord such as maintenance of fire alarms and the dating of sharps boxes.

We saw several areas of outstanding practice:

• The development of a young people specific notice board and leaflets for young people including advice and guidance for young carers and on their rights regarding being seen alone during consultations with medical practitioners
• The development of the practice smoking cessation programme which was run by a member of the administrative team

However, there was also an area where the practice must make improvements:

• Review it’s recruitment policy to ensure that appropriate pre-employment checks are carried out including references, photographic ID and confirmation of qualifications/registration with appropriate bodies when necessary.

There were also areas where the practice should make improvements:

• Ensure that only the practice staff who are appropriately trained carry out chaperone duties
• Ensure that cleaning and more regular infection control audits are completed and that all staff are appropriately trained on infection control
• Ensure that all newly appointed staff follow a comprehensive induction process and are given an opportunity for appraisal in a timely manner.
• Implement a process to monitor frequency and standard of tasks performed by the building landlord, including the maintenance of fire extinguishers and dating of sharps boxes.
• Work with practice staff to create a written business plan so that all staff are aware of vision, goals, objectives and pressures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice