Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of The Medical Centre at both locations of York Road and Rookwood Avenue on the 12 and 13 July 2016. The overall rating for the practice was good. However, a breach of legal requirements was found, resulting in a rating of requires improvement for the safe domain. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Medical Centre on our website at www.cqc.org.uk.

After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 12 HSCA (Regulated Activities) Regulations 2014 Safe care and treatment.

We undertook this focused inspection on 9 March 2017 to check that they had followed their plan and to confirm that the practice now met the legal requirements. This report only covers our findings in relation to those legal requirements.

Our key findings were as follows:

• The practice had addressed the issues identified during the previous inspection.
• All staff were aware of the systems in place to effectively manage the safe storage of vaccines and the cold chain procedures.

• Patient Specific Directions (PSDs) were in place and used by the health care assistants as appropriate. (PSDs are written instructions for medicines to be administered to a named patient after the prescriber has assessed the patient on an individual basis.)

• The practice could demonstrate what actions they took in respect of national and regional safety alerts.
• The practice had notified the Care Quality Commission of changes in their registration, for example additional GP partners.

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 The Medical Centre on 12 and 13 July 2016. Overall the practice is rated as good for providing effective, caring, responsive and well-led care. However, it requires improvement for safe.

Our key findings across all the areas we inspected were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Newly employed staff were supported in their learning and development needs.
• The practice had good facilities and was well equipped to treat and meet the needs of patients. Information regarding the services provided by the practice was available for patients.
• Overall, risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place. However, not all staff acted in line with the cold chain procedures.
• The practice was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)
• The partners promoted a culture of openness and honesty and there was a ‘being open’ policy in place, which was reflected in their approach to safety. All staff were encouraged and supported to record any incidents using the electronic reporting system. However, the abnormalities in the vaccine fridge temperatures had not been reported and acted upon.
• There was a complaints policy and clear information available for patients who wished to make a complaint.
• There was evidence of good investigation, learning and sharing mechanisms being in place with regard to reported significant events and complaints.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• The majority of patients were positive about access to the service. They said they found it generally easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• The practice sought patient views on how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.
• There was a clear leadership structure in place. Staff were aware of their roles and responsibilities and told us that the GPs and manager were accessible and supportive.

There was an area where the provider must make an improvement:

• The practice must ensure staff understand and follow the policy and procedures for the management of the vaccine fridge temperatures and the cold chain process.

There were also areas where the provider should make improvements:

• Notify the Care Quality Commission of changes to their registration in a timely manner, particularly in relation to changes in GP partners.
• Review and improve the arrangements in place to monitor what actions are undertaken in response to national and regional safety alerts.
• Have patient specific directions (PSDs) in place to enable the health care assistant to administer medicines or vaccines to patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice