Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Wirral Group Practice - AR Johnston on 19 April 2016. The overall rating for the practice was good, however we found improvements were needed under the key question is the service well led. The full comprehensive report for the April 2016 inspection can be found by selecting the ‘all reports’ link for West Wirral Group Practice - AR Johnston on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 3 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 19 April 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were that the provider had met the legal requirements and had made the following improvements:-

• An effective clinical audit programme had been implemented to assess, monitor and improve the quality and safety of services.

• An effective system was in place to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.

• An effective system had been implemented by which patient views were analysed, acted on and feedback was used to help improve services.

• All staff were trained to an appropriate level for their role in safeguarding of children and protection of vulnerable adults.

• Records relating to staff now included information relevant to their employment in the role including information relating to the requirements under Regulations 4 to 7 and Regulation19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in particular Disclosure and Barring Service checks relevant to the role.

• Records relating to staff were stored safely and securely in accordance with current legislation and guidance.

In addition the practice had made the following recommended improvements:

• Practice policies and procedures had been reviewed and revised to reflect current guidance and legislation.

• The process for learning from significant events and complaints included regular reviews to learn from themes and trends and to monitor completion of action plans.

• Arrangements for receiving and recording the response to patient safety alerts, recalls and medication safety alerts.

• The format of staff meetings had been reviewed to include documented dissemination of lessons learnt from significant incidents, events and complaints and sharing improvements from audits and patient feedback.

• Infection control audits were undertaken six monthly and action plans were documented and complete.

• The cleaning schedule had been reviewed and was now displayed. Cleaning equipment was found to be stored appropriately.

• Training, learning and development needs of staff members was reviewed at appropriate intervals (annual appraisal) and a process was in place for the on-going assessment and supervision of all staff employed which included ensuring staff are up to date with mandatory training including safeguarding, infection control.

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 Wirral Group Practice - AR Johnston on 19 April 2016. The overall rating for the practice was good, however we found improvements were needed under the key question is the service well led. The full comprehensive report for the April 2016 inspection can be found by selecting the ‘all reports’ link for West Wirral Group Practice - AR Johnston on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 3 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 19 April 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were that the provider had met the legal requirements and had made the following improvements:-

• An effective clinical audit programme had been implemented to assess, monitor and improve the quality and safety of services.

• An effective system was in place to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.

• An effective system had been implemented by which patient views were analysed, acted on and feedback was used to help improve services.

• All staff were trained to an appropriate level for their role in safeguarding of children and protection of vulnerable adults.

• Records relating to staff now included information relevant to their employment in the role including information relating to the requirements under Regulations 4 to 7 and Regulation19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in particular Disclosure and Barring Service checks relevant to the role.

• Records relating to staff were stored safely and securely in accordance with current legislation and guidance.

In addition the practice had made the following recommended improvements:

• Practice policies and procedures had been reviewed and revised to reflect current guidance and legislation.

• The process for learning from significant events and complaints included regular reviews to learn from themes and trends and to monitor completion of action plans.

• Arrangements for receiving and recording the response to patient safety alerts, recalls and medication safety alerts.

• The format of staff meetings had been reviewed to include documented dissemination of lessons learnt from significant incidents, events and complaints and sharing improvements from audits and patient feedback.

• Infection control audits were undertaken six monthly and action plans were documented and complete.

• The cleaning schedule had been reviewed and was now displayed. Cleaning equipment was found to be stored appropriately.

• Training, learning and development needs of staff members was reviewed at appropriate intervals (annual appraisal) and a process was in place for the on-going assessment and supervision of all staff employed which included ensuring staff are up to date with mandatory training including safeguarding, infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We found that patients were satisfied with the service provided at the practice. Comments made included:

“It’s excellent; everything just seems to work well. It’s very efficient”,

“A good service, everything about it is wonderful”

We found that there were suitable systems in place to gain consent from patients. Staff who obtained consent were experienced and knowledgeable in their field of expertise and were able to describe the consent process for both formal and informal consent. Staff demonstrated knowledge and understanding in the safeguarding of vulnerable adults and children.

We found that patients care and treatment was assessed, planned and delivered in order to meet their needs. Care and treatment plans were documented and reviewed and patients were fully informed and involved in their care or treatment.

Staff were trained and appraised appropriately and there was monitoring of training and development needs. Staff told us they were well supported by the manager and by the partner GPs.

We found the provider had effective systems in place for monitoring the quality of services with an embedded culture of clinical governance evident. (Clinical governance is a systematic approach to maintaining and improving the quality of patient care and safeguarding high standards of care within a healthcare system). There was an active Patient Participation Group (PPG), current policies and procedures and learning from complaints, incidents and significant events.