We carried out an announced comprehensive inspection at The Arthington Medical Centre on 17 October 2018, as part of our inspection programme.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from the provider, patients, public, other organisations and our ongoing monitoring of data about services.

We have rated this practice as good overall.

We concluded that:

• Patients were protected from avoidable harm and abuse and that legal requirements were met.
• Patient care and treatment was delivered in line with current best practice guidance.
• The leadership, governance and culture of the practice promoted the delivery of quality person-centred care.

However, we also found that:

• Some staff informed us that communication systems within the practice did not always meet their needs. They told us they did not always feel they were supported to raise concerns.
• It was noted that records were not available for all staff to assure the practice of their occupational health immunisation status.
• Less than 2% of registered patients had been identified as a carer.

We rated the practice as requires improvement for providing caring services because:

• Patients’ satisfaction with how cared for they felt was consistently, and in some cases significantly, below local and national averages. This included a significant proportion of patients surveyed who claimed the healthcare professional they last had an appointment with was good or very good at treating them with care and concern.
• The provider informed us they were striving hard to improve patient satisfaction overall. However, the impact of this work had not been formally assessed at the time of inspection.

Whilst we found no breaches of regulations, the provider should:

• • Review how communications with staff could be improved to support staff raising concerns.
  • Review and improve the process to ensure that the immunisation status, regarding occupational health, of newly recruited staff is recorded.
  • Monitor and work to improve patient satisfaction regarding their experience at the practice.
  • Work to improve the identification of patients who act in the capacity of a carer.

  Details of our findings and the evidence supporting our ratings are set out in the evidence table.

  Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice