This practice is rated as Good overall. (Previous inspection 08/2017 – Requires Improvement)

The key questions are rated as:

Are services safe? – Good

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 The Neville Family Medical Centre on 5 June 2018.

At this inspection we found:

• The practice had clear 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. The significant event process had been improved with learning and follow ups included in the cycle.
• Staff demonstrated that they understood their responsibilities to safeguarding children and vulnerable adults. All staff had the approiate level of training in place.
• 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.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Results from the national GP patient survey had increased to show that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• The practice sponsored a local school and provided their rugby team with their sport kit.

We saw one area of outstanding practice :

• The practice nurse had developed a “Flare up” register for all patients with a respiratory disease (which are diseases of the airways and other structures of the lungs). The patients journey were closely monitored by the nurse. Administrative staff and patients were aware of the process and appointments were made for patients to ensure a continuity of care was maintained by the nurse. Patients were signposted to external support services and educated on symptoms and technics, whilst being provided with a flare up plan, using a flag system to identify symptoms and trigger alerts to seek help.

The areas where the provider should make improvements are:

• Increase the time the clinical partner spends in the practice to support the salaried GPs.
• Undertake a full premises / security risk assessment for the practice.
• Continue to increase and review the numbers of carers within the practice.
• Staff to access online training in equality and diversity and health and safety training.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Neville Family Medical Centre on 8 August 2017. Overall the practice is rated as requires improvement.

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

• The practice had a number of policies and procedures to govern activity and support the delivery of good quality care. However we found that not all staff were aware of these procedures and each were following different processes. After the inspection the practice told us they had started a full review of all current processes.
• Risks to patients were not always assessed and well managed including those relating to recruitment, health and safety and fire safety. After the inspection the practice told us that they had sourced two quotes and had plans to carry out a fire risk assessment.
• A limited number of clinical audits had been carried out; however these were not two cycle audits and did not show that they were driving quality improvement.
• Staff demonstrated that they understood their responsibilities to safeguarding children and vulnerable adults; however on the day of inspection, it was unclear from the practices’ records whether all non-clinical staff had received training on safeguarding.
• Clinical staff were aware of current evidence based guidance. Clinical staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Some results from the national GP patient survey were below average, but did show that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• The practice sponsors unisex sports clothing for the school, which can be used by both male and female sports teams at the school.

• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvement are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.
• 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.

The areas where the provider should make improvements are :

• Review and improve the access arrangements to the building for less mobile patients.
• Assess the need to develop a programme of full team meetings.
• Continue to work on improving patient satisfaction rates with the care and services provided.
• Review the location of the emergency medicines key.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice