Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rusthall Medical Centre on 7 July 2016. The overall rating for the practice was requires improvement (rated as Requires improvement for providing safe and well-led service and Good for providing effective, caring and responsive services). The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Rusthall Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 4 May 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 7 July 2016. 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:

• Since our inspection in July 2016 the practice had improved its systems and processes for the monitoring and recording of investigations into significant events.

• Staff had received relevant training for safeguarding children and adults, infection control and Health and Safety.

• A system for the recording, secure storage of and auditing of prescription pads and printer compatible prescription forms had been implemented.

• Recruitment procedures had been updated to help ensure that all appropriate recruitment checks were undertaken prior to employment of staff.

• The practice had improved its governance processes in order to help ensure that all governance documents including policies, protocols and minutes of meetings were up to date and accessible to all staff.

• The provider was able to fully demonstrate compliance with the requirements of the duty of candour.

The practice had also taken appropriate action to address areas where they should make improvements:

• Appropriate action had been taken to ensure staff were aware of the vision and strategy and their responsibilities in relation to them.

• The staff induction programme had been updated to incorporate a record and audit trail of the training received by newly employed staff.

• The communication of information and change to all staff had been improved in order to ensure it was effective and auditable.

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 Rusthall Medical Centre on 7 July 2016. Overall the practice is rated as requires improvement.

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

• There was a system for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, reviews and investigations were not sufficiently robustly recorded and auditable, the practice policy was not complied with by all staff and there was insufficient evidence of the duty of candour being complied with.

• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. However, the practice was unable to demonstrate that all relevant staff were up to date with safeguarding training, infection control training and health and safety training.

• Data showed that patient outcomes were better than the national average. We saw evidence that audits were driving improvements to patient care and outcomes.

• Patients said they were treated with compassion, dignity and respect and that 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. Urgent appointments were available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Governance arrangements were not always effectively implemented. The practice had a number of policies and procedures to govern activity. However, some were not dated and limited in detail. Staff did not know where to find the majority of policies and did not have access to them, and methods of disseminating information were not robust and auditable.

• The practice was proactive in pursuing continuity of care with patients being cared for by their designated named GP.

The areas where the provider must make improvement are:

• Revise the system of significant event management to ensure that there is a robust record of investigations, actions and outcomes and that the practice is complying with the duty of candour.

• Ensure that all employed staff receive mandatory training

• Revise medicines management to ensure that blank prescription forms are stored securely and blank prescription forms and pads are monitored through the practice.

• Revise recruitment management to ensure that all appropriate recruitment checks are undertaken prior to employment of staff.

• Revise governance processes and ensure that all governance documents including policies, protocols and minutes of meetings are up to date and accessible to all staff.

In addition the provider should:

• Ensure that all attendances at training are formally recorded.

• Ensure that the staff induction programme incorporates a record and audit trail of the training received.

• Ensure that the communication of information and change to all staff is auditable.

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 Rusthall Medical Centre on 7 July 2016. The overall rating for the practice was requires improvement (rated as Requires improvement for providing safe and well-led service and Good for providing effective, caring and responsive services). The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Rusthall Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 4 May 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 7 July 2016. 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:

• Since our inspection in July 2016 the practice had improved its systems and processes for the monitoring and recording of investigations into significant events.

• Staff had received relevant training for safeguarding children and adults, infection control and Health and Safety.

• A system for the recording, secure storage of and auditing of prescription pads and printer compatible prescription forms had been implemented.

• Recruitment procedures had been updated to help ensure that all appropriate recruitment checks were undertaken prior to employment of staff.

• The practice had improved its governance processes in order to help ensure that all governance documents including policies, protocols and minutes of meetings were up to date and accessible to all staff.

• The provider was able to fully demonstrate compliance with the requirements of the duty of candour.

The practice had also taken appropriate action to address areas where they should make improvements:

• Appropriate action had been taken to ensure staff were aware of the vision and strategy and their responsibilities in relation to them.

• The staff induction programme had been updated to incorporate a record and audit trail of the training received by newly employed staff.

• The communication of information and change to all staff had been improved in order to ensure it was effective and auditable.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice