This practice is rated as Good overall. (Previous rating June 2016 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at St Georges Medical Centre.

At this inspection we found:

• Personalised care plans were not in place to meet patient’s individual needs or reflect their individual preferences.
• Not all staff were aware of current evidence based guidance, for example one GP was not aware of the frailty index for older patients.
• The practice had systems in place to document significant events but clinical and non-clinical staff lacked understanding of what constituted a significant event, with threshold for reporting significant events extremely high.
• 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 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.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Assess the need to develop a programme of full team meetings and minute clinical meetings held.
• Infection control should cover all areas in the practice and have a completed action plan.
• Patient Participation Group (PPG) to be more focused on the wider scope of patients.
• Develop a job description for the new role within the practice.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of St Georges Medical Centre on the 9 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was good for providing services for all the population groups we assessed.

Our key findings were as follows:

• There were systems in place to protect patients from avoidable harm, such as from the risks associated with medicines and infection control. Equipment used by staff was checked for its safety. The practice had systems in place for reporting, recording and monitoring safety incidents.

• Patients’ care needs were assessed and care and treatment was in line with best practice national guidelines. Staff were proactive in promoting patients’ good health. The practice nurse’s annual leave was not always covered by agency staff, rather their work was divided up between other clinical staff. This impacted on patients' care as we were informed patients raised concerns about this.

• Most patients spoken with confirmed they were always treated with dignity and respect and clinical staff explained their treatments and they listened to what they had to say. The practice manager acted as a non-clinical cancer champion to ensure a smooth care package. Some patients raised concerns about the reception staff who they described as rude and unhelpful.

• Quality and performance were monitored, risks were identified and managed. Staff told us they could raise concerns and felt listened to and well supported. Patients were generally dissatisfied with the appointments system and found it difficult to book an appointment. Only half of the patients spoken with said they knew how to make a complaint. The complaint procedure was not displayed in the patient waiting area.

• The practice vision was to deliver high quality care and promote good outcomes for patients. Meetings took place to share information and look at where service improvements were needed. Training was provided to support staff with their professional development.

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

The provider should:

• The provider should offer patients a chaperone when they have personal examinations.
• The provider should provide information about who patients should contact if they have a concern about the safety of another adult or child.

• The provider should ensure effective staffing levels are provided when nursing cover is unavailable.
• The provider should ensure patients can access appointments with a GP more easily.
• The provider should provide information about who patients can contact for medical assistance when the practice is closed.
• The provider should offer patients information about how to make a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice