We carried out an announced comprehensive inspection at RHR Medical Centre on 11 May 2017 and 23 May 2017. The overall rating for the practice was requires improvement with a rating of inadequate for providing well-led services. The full comprehensive report from May 2017 can be found by selecting the ‘all reports’ link for RHR Medical Centre on our website at www.cqc.org.uk.

The overall rating of requires improvement will remain unchanged until we undertake a further full comprehensive inspection of the practice within the six months of the publication date of the report from May 2017.

This inspection was a focused inspection carried out on 1 December 2017 to confirm that the practice had taken the required action to meet the legal requirements in relation to the breach in regulation set out in a warning notice issued to the provider. The warning notice was issued in respect of a breach of regulation related to good governance.

Our key findings were as follows:

• The practice had complied with the warning notice we issued and had taken the action needed to comply with legal requirements.
• New systems had been introduced to ensure staff were provided with the training relevant to their role.
• Systems to identify, monitor and mitigate risk had been improved in respect of risks related to fire and legionella.
• Systems to monitor access to appointments had been improved and there was additional GP capacity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RHR Medical Centre in May 2017. The overall rating for the practice was requires improvement.

We carried out a focused inspection in December 2017 to confirm that the practice had taken the required action to meet the legal requirements in relation to the breaches in regulation set out in warning notices issued to the provider following our May 2017 inspection. The warning notice was issued in respect of a breach of regulation related to good governance.

The full reports from the previous inspections can be found by selecting the ‘all reports’ link for RHR Medical Centre on our website at www.cqc.org.uk.

This inspection was a comprehensive inspection with a site visit undertaken on 1 March 2018. RHR Medical Centre is one of four locations of the provider ‘The Beechdale Medical Group’, All four locations were inspected between 22 February 2018 and 7 March 2018. The overall rating for this location is good.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

Our key findings were as follows:

• Clear systems had been introduced to identify, assess and monitor risks so that safety incidents were less likely to happen. Where incidents occurred, the practice considered these as opportunities for learning.
• Effective recording systems had been introduced to ensure significant events and incidents were monitored and reviewed. Learning was shared across the practice group.
• Arrangements to respond to emergencies had been significantly improved; arrangements had been standardised across the practice group.
• Regular risk assessments were undertaken including risk assessments in respect of fire safety.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff were supported to access the training required to fulfil their roles and received regular appraisals. Arrangements for the support and supervision of nursing staff had been strengthened.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Leadership arrangements had been reviewed and improved across the practice group; this included the recruitment of a new business manager to provide strategic and operational leadership.

However, there were also areas of practice where the provider should make improvements.

The provider should:

• Continue to improve the use of the clinical system to ensure all tasks are managed appropriately

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice