Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Roman Way Medical Centre on 12 January 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the 12 January 2017 inspection can be found by selecting the ‘all reports’ link for Roman Way Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk based review carried out on 26 September 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 at our previous inspection on 12 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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Overall the practice is now rated as good.

Our key findings were as follows:

• Processes were in place to ensure QOF performance was monitored with a view to improvement..

• Systems were in place to improve the uptake for the national cervical screening programme.

• The practice had undertaken a patient survey into the provision of nursing care and found an improvement in the way the nurse listened, treated patients and involved them in their care.

• Processes were in place to raise the awareness of carers.

• A cleaning schedule for the cleaning of hand held clinical equipment had been produced and was up to date.

• All medical emergency equipment was housed in one place and all staff were aware of the location.

The areas where the provider should make improvement are:

• Continue to monitor and improve the cervical screening uptake rate.

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 Roman Way Medical Centre on 12 January 2017. Overall the practice is rated as requires improvement.

The practice was previously inspected in March 2016. It was given an overall rating of requires improvement. The practice was found good for providing an effective and responsive service and requires improvement for providing a caring and well led service. The practice was found inadequate for providing a safe service and was found in breach of regulations 12 (safe care and treatment), 17 (good governance), 18 (staffing) and 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. When we re-inspected we found that the matters leading to these breaches had been addressed.

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

• The practice was aware of the performance challenges outlined in the poor QOF (Quality and Outcomes Framework) scores and had put a plan in place to address this and improve outcomes for patients.
• The practice scored below average for many of the scores in the national patient survey, especially those relating to nursing services. The practice was aware of this and were putting plans in place to address this including putting performance plans for members of staff.
• Risks to patients were assessed and managed. However emergency equipment was housed in a number of locations within the nurse’s room and not easy to get in an emergency. There was no log of cleaning of hand held clinical equipment such as spirometer, nebuliser or ear irrigator.
• There was an open and transparent approach to safety and a system was in place for reporting and recording significant events.
• 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 services 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 named GP and there was continuity of care, with urgent appointments available the same day. However once at the practice, patients said that there was a long wait to see the GP. The practice was aware of this matter and were addressing it with individual GPs.
• 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 sought feedback from staff and patients, which it acted on. The practice had developed a virtual patient participation group (PPG) following the difficulties found in forming a physical PPG.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Investigate further ways to improve QOF scores.

• Identify ways to improve the scores from the national patient survey in relation to patient satisfaction with the service.

The areas where the provider should make improvement are:

• Produce a schedule for the cleaning of hand held clinical equipment.

• Ensure emergency equipment is easily accessible and that all staff know of the location.

• Look into ways to improve the uptake for the cervical screening programme.

• To review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

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 Roman Way Medical Centre on 12 January 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the 12 January 2017 inspection can be found by selecting the ‘all reports’ link for Roman Way Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk based review carried out on 26 September 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 at our previous inspection on 12 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

.

Overall the practice is now rated as good.

Our key findings were as follows:

• Processes were in place to ensure QOF performance was monitored with a view to improvement..

• Systems were in place to improve the uptake for the national cervical screening programme.

• The practice had undertaken a patient survey into the provision of nursing care and found an improvement in the way the nurse listened, treated patients and involved them in their care.

• Processes were in place to raise the awareness of carers.

• A cleaning schedule for the cleaning of hand held clinical equipment had been produced and was up to date.

• All medical emergency equipment was housed in one place and all staff were aware of the location.

The areas where the provider should make improvement are:

• Continue to monitor and improve the cervical screening uptake rate.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice