Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Malling Group Practice on 30 November 2016. The overall rating for the practice was good. The practice was rated as requires improvement for providing responsive services and rated as good for providing safe, effective, caring and well-led services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for West Malling Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused desk based inspection conducted on 27 September 2017 to confirm that the practice had carried out their plan to address the issues identified in our previous inspection on 30 November 2016. This report covers our findings in relation to those improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had taken appropriate action to address areas where they should make improvements. They had continued with their action plan in order to help ensure national patient survey results improve.

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 West Malling Group Practice on 23 February 2016. Breaches of the legal requirements were found.

• There was a system to review and investigate incidents and near misses. Incidents were investigated and changes were made to help prevent their recurrence. However, not all staff understood and fulfilled their responsibilities to report incidents.

• The practice received national patient safety alerts and communicated them to relevant staff. However, they did not maintain records of the actions staff took in response to national patient safety alerts.

• Patients said they did not find it easy to make an appointment with a GP, although the practice had taken steps to address this and urgent appointments were available the same day. The practice made efforts to ensure patients understood how to make an appointment and kept the process for accessing appointments under review.

• There was a clear leadership structure and staff felt supported by management. However, governance arrangements were not always effectively implemented.

Therefore, Requirement Notices were served in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulations 12 - Safe care and treatment and Regulation 17 - Good Governance.

Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches.

We undertook this focussed inspection on 30 November 2016, to check that the practice had followed their plan and to confirm that they now met the legal requirements. At our focussed follow-up inspection on 30 November 2016, the practice provided records and information to demonstrate that the requirements had been met in relation to providing safe services. However, the practice remained rated as requires improvement for providing responsive services. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for West Malling Group Practice on our website at www.cqc.org.uk.

The areas where the provider should make improvement are:

• Continue with their action plan in order to help ensure national patient survey results improve.

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 West Malling Group Practice on 23 February 2016. Overall the practice is rated as requires improvement.

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

• There was a system to review and investigate incidents and near misses. Incidents were investigated and changes were made to help prevent their recurrence. However, not all staff understood and fulfilled their responsibilities to report incidents.
• The practice received national patient safety alerts and communicated them to relevant staff. However, they did not maintain records of the actions staff took in response to national patient safety alerts.
• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they did not find it easy to make an appointment with a GP, although the practice had taken steps to address this and urgent appointments were available the same day. The practice made efforts to ensure patients understood how to make an appointment and kept the process for accessing appointments under review.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. However, governance arrangements were not always effectively implemented.
• The practice acted on feedback from staff and patients.
• The practice had an active patient participation group that worked with the management of the practice to improve services to patients.

The areas where the provider must make improvements are:

• Ensure all staff understand their responsibilities to report safety incidents and near misses and revise national patient safety alert management to ensure staff record that they have read them and taken action when appropriate.
• Revise governance management to ensure governance arrangements are effectively implemented.
• Ensure that access arrangements are continually monitored and improved, and clearly communicated to patients.

In addition the provider should:

• Ensure that all risks to patients are assessed and action taken to reduce risk where possible especially in relation to appropriate recruitment checks prior to employment for all staff.
• Proactively identify patients who are carers and offer them support.
• Ensure that verbal complaints that are informally resolved are recorded and analysed.
• Revise consent forms to ensure that the GPs’ explanations of possible side effects and complications can be recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice