We carried out an announced comprehensive inspection at Shinfield Health Centre on 13 September 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the September 2017 inspection can be found by selecting the ‘all reports’ link for Shinfield Health Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 March 2018 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 13 September 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:

• There was an appropriate system in place to respond to complaints and share learning arising from complaints.
• There was an effective system in place for keeping emergency equipment and medicines needed for medical emergencies. Both equipment and medicines were regularly checked.
• Staff received training appropriate to their roles.
• The practice had an action plan underway to improve access to the practice by telephone and to appointments. Whilst the actions identified were underway it was too early to evaluate whether they would be effective in improving access to the service.
• Staffing structures had been reviewed and recruitment campaigns launched to increase clinical staffing levels. Two part time practice nurses and a clinical pharmacist had been recruited.
• Staff were involved in the management of the practice via a weekly team meeting attended by team leaders and the partners.

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

Importantly, the provider should:

• Monitor implementation of their action plan and evaluate whether actions taken to improve access are effective.

At our previous inspection on 13 September 2017, we rated the practice as requires improvement for providing responsive services because feedback from patients was poor in regard to accessing the practice by telephone and obtaining appointments. At this inspection we found that the practice had clear plans in place to address patient feedback. However, the plan had commenced and there was further work to be undertaken. It was too early to evaluate if the plan would improve access. Consequently, the practice is still rated as requires improvement for providing responsive services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

The practice is managed by a GP partnership. It was previously registered with CQC to be managed by an individual GP who remains as one of the partners. This announced comprehensive inspection was undertaken on13 September 2017 to assess whether the new provider partnership complied with regulations.

Overall the practice is rated as requires improvement. Specifically it is rated good for provision of safe, caring and effective services but requires improvement for providing responsive and well led services.

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 systems to minimise risks to patient safety however some issues relating to inconsistent management of medicines were addressed on the day of inspection.
• 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.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• Feedback from patients who took part in the GP National Survey was below average for several aspects of care and responsiveness. The practice had not addressed this feedback in a timely manner.

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

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• Ensure consistent systems to secure blank prescription pads are maintained.
• Ensure medicines for use in an emergency are securely stored whilst accessible to staff.

Because the practice requires improvement we will re-inspect within six months to check that improvements have been made.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice