Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sovereign Medical Centre on 1 August 2017. The overall rating for the practice was good with the practice rated as requires improvement for being safe.

From the inspection on 1 August 2017, the practice were told they must:

• Ensure care and treatment was provided in a safe way to patients. In particular, newly developed systems for managing safety alerts must be implemented effectively and recruitment checks must be completed for all staff.

In addition the practice were told they should:

• Monitor newly developed systems to manage patients taking high risk medicines to ensure they were working effectively.
• Ensure that staff completed all mandatory training in a timely manner and have adequate protected time within which to do so.
• Develop systems to identify and support more carers in their patient population.

The full comprehensive report on the inspection carried out in August 2017 can be found by selecting the ‘all reports’ link for Sovereign Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 1 May 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 1 August 2017. This report covers our findings in relation to those requirements and improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Systems had been improved to ensure that appropriate action was taken in response to safety alerts to reduce risks to patient safety. Records of alerts received and action taken were kept securely.
• The practice carried out appropriate staff checks at the time of recruitment and on an ongoing basis.

Additionally where we previously told the practice they should make improvements our key findings were as follows:

• The arrangements for managing high risk medicines in the practice minimised risks to patient safety. In particular, there were adequate processes in place to reduce risks to patients taking high risk medicines.
• The majority of staff had completed all mandatory training and this was coherently recorded by the practice manager. We saw evidence that protected time was available to staff to ensure training was undertaken. Where staff had missed training events timescales were established to ensure completion of all training. We were informed that the outstanding update training for one member of staff was scheduled for completion by the end of May 2018.
• The practice had made considerable efforts to identify and support more carers in its population. At the time of our inspection the practice had identified 97 patients as carers (less than 1%). This was a marked improvement on the 52 patients identified as carers in August 2017. We saw evidence that the practice had engaged with MK Carers (a local organisation providing support and advice to carers) to further develop the support they could offer to carers and to devise an action plan for the future.

The areas where the provider should make improvements are as follows:

• Continue with efforts to identify more carers in order to offer them support.

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 Sovereign Medical Centre on 1 August 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected 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. However systems for managing safety alerts and actions taken in response to them required improvement.
• 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 most recent national GP patient survey showed patients rated the practice higher than others for all aspects of care. Patients said they were treated with dignity and respect and they were involved in decisions about their care and treatment.
• Feedback from patients about their care and treatment was consistently and strongly positive.
• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments 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.

We saw one area of outstanding practice:

• The practice made efforts to respond to the needs of its minority populations. The practice had recognised that patients of South Asian origin were not utilising health services appropriately. The practice organised a health promotion event at a local community hall and invited people of south Asian origin to attend. The practice engaged with other local services such as the police and public health departments to enable them to also reach out to these populations. The practice had continued to facilitate and support these meetings weekly for the last ten years.

The areas where the provider must make improvement are:

• Ensure care and treatment is provided in a safe way to patients. In particular, newly developed systems for managing safety alerts must be implemented effectively and recruitment checks must be completed for all staff.

The areas where the provider should make improvement are:

• Monitor newly developed systems to manage patients taking high risk medicines to ensure they are working effectively.

• Ensure that staff complete all mandatory training in a timely manner and have adequate protected time within which to do so.

• Develop systems to identify and support more carers in their patient population.

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 Sovereign Medical Centre on 15 December 2015. Overall the practice is rated as good.

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.
• There were appropriate systems in place to reduce risks to patient safety, for example, infection control procedures and the management of medication.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients were extremely positive about the care they received at the practice. They commented that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Services were planned and delivered to take into account the needs of different patient groups.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments 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 patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

However, there were some areas where the provider should make improvement:

• Develop a system to ensure all staff receive regular appraisals of their skills, abilities and development requirements.

• Demonstrate that they have obtained satisfactory information about the employment history of staff.

• Ensure that fire drills are performed routinely.

• Review and assess the systems in place to ensure that emergency medicines are always available and ready to use.

• Ensure that information is available to patients and is up to date, particularly with regard to the process for raising a complaint.

• Perform regular audits to evaluate and improve the quality of services provided.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice