Blandford Medical Centre in Braintree is a Doctors/GP specialising in the provision of services relating to diagnostic and screening procedures, family planning services, maternity and midwifery services, services for everyone, surgical procedures and treatment of disease, disorder or injury. The last inspection date here was 28th July 2017
Blandford Medical Centre is managed by Blandford Medical Centre.
Contact Details:
Address:
Blandford Medical Centre Mace Avenue Braintree CM7 2AE United Kingdom
Letter from the Chief Inspector of General Practice
On 25 August 2016 we carried out a comprehensive inspection at Dr D A Williams & Partners. Overall the practice was rated as requires improvement. The practice was found to be good in providing effective and caring services. However, they required improvement in providing safe, responsive and well-led services.
A requirement notice was issued to the provider for safe care and treatment and poor governance. The concerns related to infection control audits that were not in line with guidance, the system for acting on patient safety and medicine alerts was not effective, the learning from significant events was not routinely being discussed and learning had not been embedded into practice procedures and the practice did not have a system of quality improvement in place to assess and monitor the services provided or to act on high exception reporting. The full report for the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr D A Williams & Partners on our website at www.cqc.org.uk.
As a result, we carried out a focused inspection of the practice on 15 June 2017 to establish whether the required improvements had been met. We found adequate improvements had been made; overall the practice is rated as good.
Our key findings across all areas we inspected were as follows:
The practice had reviewed their data from the national GP patient survey and acted on patient suggestions to improve patient satisfaction.
The practice had appropriate policies and procedures in place that were reviewed annually.
The patients we spoke with on the day of the inspection said they found it difficult to book an appointment and contact the practice by telephone. However the practice had reviewed their telephone system to help improve patient satisfaction.
The practice had worked with their participation group to make improvements related to patient feedback.
Staff understood their roles and responsibilities and how these contributed directly to improving patient experiences of the service and the practices performance.
The practice had conducted an infection control audit which was monitored by the infection control lead who had received adequate training to carry out the role.
Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) were accessible to relevant staff members and in line with national guidance.
The system for managing patient safety and medicine alerts was effective, appropriate action was taken and recorded.
The governance at the practice ensured that risks to patients and staff were identified and mitigated.
Exception reporting was assessed and monitored to improve performance.
Significant events were cascade to all staff members however learning from such events were not always documented.
The practice had identified 87 patients as a carer which was 0.5% of their patient list.
The business continuity plan was up to date and reviewed regularly.
Prescription forms for use in computers were recorded and tracked through the practice, however individual prescription pads were not being tracked.
All non-clinical staff received safeguarding training for children and vulnerable adults.
Staff were aware of patient confidentiality during private conversations.
Action the service SHOULD take to improve:
Continue to monitor and act upon patient satisfaction data.
Review process and methods for identification of carers and the system for recording this to enable support and advice to be offered to those that require it.
Ensure blank prescriptions are tracked in accordance with national guidance.
Ensure that the learning from significant events is recorded.
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr A D Williams & Partners also known as Blandford Medical Centre on 25 August 2016. Overall the practice is rated as requires improvement.
Our key findings across all the areas we inspected were as follows:
There was limited use of systems to record and report safety concerns, incidents and near misses. Some staff spoken with were not clear how to raise concerns.
Systems, processes and practices were not always reliable or appropriate to keep patients safe. Monitoring whether safety systems were implemented was not given sufficient priority and some staff lacked knowledge about the process.
The arrangements for governance and performance management did not always operate effectively. There had been no recent review of the governance arrangements, the strategy, plans or the information used to monitor performance.
The practice had signed authorities in relation to Patient Specific Directions and Patient Group Directions but not all had been signed by an authorising person.
Patients said they were treated with compassion, dignity and respect. We saw that staff treated patients appropriately although confidentiality could not always be assured in the reception area.
The practice had identified a low number of patients who were carers.
Prescription stationery was kept securely at all times and only accessible to authorised staff; however the issuing of prescription forms was not being recorded.
There was a named GP responsible for the dispensary and all members of staff involved in dispensing medicines were trained appropriately.
Clinical staff had the skills, knowledge and experience to deliver effective care and treatment. However, some non-clinical staff had not received safeguarding training.
Staffing levels and skill mix were planned in advance and reviewed to ensure patients received safe care.
For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.
Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
The practice had good facilities and was well equipped to treat patients and meet their needs.
Appointment availability was an issue identified by staff and patients although survey data was in line with local and national averages. The practice was working to improve the current system.
The areas where the provider must make improvement are:
Ensure all Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) are correctly authorised for clinical staff to administer vaccines and immunisations in line with national requirements.
Carry out infection control audits in line with published guidance. Ensure that the infection control lead has received adequate training for the role.
Ensure that the system for managing patient safety and medicine alerts is effective and that appropriate action is taken and recorded.
Improve the governance at the practice to ensure that risks to patients and staff are identified and mitigated. Ensure that systems are effective in relation to assessing and monitoring the performance of the practice by having oversight of high exception reporting and an action plan to improve performance.
Improve the system in place in relation to significant events to cascade the learning from such events and to ensure that the changes made are embedded in the practice.
The areas where the provider should make improvement are:
Take steps to identify more carers and provide them with support that meets their needs.
Ensure the business continuity plan is up to date and reviewed regularly.
Ensure the issuing of prescription stationery is recorded.
Ensure that all non-clinical staff receive an appropriate level of safeguarding training for children and vulnerable adults.
Ensure that staff are implementing practice policies, that they are up to date and the subject of a review process.
Take steps to reduce the risk of private conversations being overheard at the reception area in order that patient confidentiality can be maintained.
Continue to monitor the effectiveness of the new phone system in relation to patient satisfaction.
We found one area of outstanding practice;
The practice had collected mortality data over a period of ten years and used this to ensure that their systems were effective. The practice used this data to identify trends in relation to its patient population groups to ensure there were no emerging themes with regards to the mortality of practice patients. This information had been shared with its commissioning group.
During our inspection we saw that on arrival at the service people could speak to reception staff or use the touch in booking screen. People told us staff treated them respectfully and were helpful. We saw that consultations were carried out in private treatment rooms. One person told us: “When I come to the GP, I feel the staff do listen to me. Sometimes it can be difficult to get an appointment. It’s a busy surgery but I wouldn’t want to change.” Another person told us they thought the service was nice and the staff were professional.
Information was clearly displayed for people, this included health promotion, access to support services and information about the practice and the services provided. People told us they were happy with the service and felt they received appropriate treatment and support. There were systems in place for dealing with foreseeable emergencies.
During our inspection we saw that medicines were handled appropriately and stored safely. We saw from the records we reviewed that staff were trained and supported in their role. Staff had received supervision and appraisal.
We saw that people’s records were accurate and stored securely.
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