This practice is rated as requires improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at Tangmere Medical Centre on 27 November 2018 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However, the practice did not always ensure that action as result of significant events were followed up.
• The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they could access care when they needed it.
• Patient feedback was consistently positive and the results of the national GP patient survey were higher than the clinical commissioning average in every area.
• Most staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Governance arrangements for the dispensary needed to be improved.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Develop a central record that provides a clear audit trail of action taken in response to external medicine and patient safety alerts.
• Ensure the flooring in the treatment rooms minimises the risk of infection control.

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

The practice was rated good overall and is now rated good for providing safe services.

We carried out an announced comprehensive inspection of this practice on 31 March 2016. A breach of legal requirements was found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 19 January 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 31 March 2016 we found the following areas where the practice must improve:

• Put arrangements in place to ensure the safe management of medicines.

Our previous report also highlighted the following areas where the practice should improve:

• Ensure significant events and near misses in the dispensary and the practice are consistently recorded and shared. Include non-clinical events so that learning opportunities are maximized.
• Ensure accurate recruitment records for all staff.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 19 January 2017 we found:

• The provider now had arrangements in place for the safe management of medicines.

We also found in relation to the areas where the practice should improve:

• Significant events in the practice and the dispensary were consistently recorded and shared. Non clinical events were now included.
• There were accurate recruitment records for staff which included written records of references obtained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice