Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Medical Centre on 19 May 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the 19 May 2016 inspection can be found by selecting the ‘all reports’ link for Parkside Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 22 June 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were below local and national standards for showing patients were treated with compassion, dignity, respect and for showing patients were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they sometimes found it difficult to make an appointment with a named GP; however, urgent appointments were 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice provided extended hours three times a week, Monday and Wednesday 6.30pm-8pm and Friday 7am-8am.

• The practice was in a transition stage of using a new data management system that would record, complaints, significant events, training, recruitment, minutes, and alerts.

The areas where provider should make improvements:

• Continue to review uptake of child immunisations rates.

• Monitor patient satisfaction with access and appointment availability, including improving patient satisfaction with compassion, dignity, respect and involvement in decisions on care.

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 Parkside Medical Centre on 19 May 2016. Overall the practice is rated as requires improvement.

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.

• One member of staff told us that they would stand with their view obstructed which chaperoning which was not in accordance with current best practice and this service was not advertised in the waiting area.

• Risks related to infection control and fire safety were not always assessed or well managed.
• Processes around the management of medicines were not effective and did not guarantee patient safety.
• Though staff assessed the majority of patients’ needs and delivered care in line with current evidence based guidance; there was evidence to suggest that they were not following current best practice in respect of capacity assessments for minors.
• 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 though the practice’s complaints procedure was not clearly advertised in the reception area and some of the practice’s complaint responses did not include information on who patients could contact if they were dissatisfied with the practice’s response. Improvements were made to the quality of care as a result of complaints and concerns.
• Not all patients said they found it easy to make an appointment with a named GP. Urgent appointments available the same day.
• The practice had policies and procedures in place which were easily accessible to staff though some policies were not specific to the practice, were not subject to periodic review or contained incorrect information.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from patients and allowed staff to contribute ideas and suggestions.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Ensure that the policies and procedures around capacity and consent reflect current legislation and guidance and that all staff are acting in accordance with this.

• Ensure that policies and procedures around chaperoning, the management of medicines (including emergency medicines, vaccines, Patient Group Directions and prescriptions) reflect current legislation and guidance and that all staff are acting in accordance with this.

• Ensure that all practice policies are specific to the needs of the practice and that they are subject to regular review and updated when required.

• Ensure that risks associated with infection control and fire safety are assessed and that mitigating actions are taken where required.

The areas where the provider should make improvement are:

• Ensure suitable toilet facilities are available to patients

• Take steps to improve the identification of people with caring responsibilities among their practice population so they can provide effective support and signposting.

• Continue to work to address the low scoring areas relating to access that were highlighted in the National Patient Survey.

• Ensure the complaints policy and responses comply with relevant legislation.

• Ensure all staff undertaking chaperoning are appropriately trained.

• Complete induction checklists for new members of staff.

• Clearly advertise chaperoning, complaints and translation services in the practice waiting area.

• Increase the amount of quality improvement work undertaken.

• Continue to review the patient list to improve identification of patients with chronic obstructive pulmonary disease and chronic heart disease.

• Continue to review staffing arrangements to ensure that there are a sufficient number of staff to meet patient demand and provide continuity of care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice