This practice is rated as Good overall. (Previous rating 15/03/2018 – Good with Requires Improvement in Safe)

The key question of safe is now rated as Good.

We carried out a comprehensive inspection of Bloomfield Medical Centre on 15 March 2018. The overall rating for the practice was good with the key question of safe rated as requires improvement. The practice were unable to evidence up to date systems for the risk assessment of fire safety and associated training. A requirement notice under Regulation 12 was issued. The full comprehensive report on the 15 March 2018 inspection can be found by selecting the ‘all reports’ link for Bloomfield Medical Centre on our website at www.bloomfieldmedical.co.uk.

This desk top review was carried out on 03 October 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach identified in the requirement notice.

Our key findings were as follows:

The practice had done all that was reasonably practicable to mitigate risks to the health and safety of service users receiving care and treatment.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

This practice is rated as Good overall. (Previous inspection March 2016 the practice was rated good overall – Good)

The key questions are rated as:

Are services safe? – Require Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) – Good

We carried out an announced comprehensive at Bloomfield Medical Centre on 15 March 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The leadership at the practice had a clear vision, which put working with patients to ensure high quality care and treatment as its top priority. There was a commitment by all the practice staff to deliver a quality service.
• There was a good understanding of the local population health and social care needs and recognition of the specific challenges this provided to the practice in delivering high quality care and treatment.
• 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. A range of policies and procedures were available however we noted some required updating and some clinical protocol for practice nurse activities required development
• The practice held weekly informal clinical meetings where patient and practice issues were discussed however minutes of these meetings were not recorded. The clinical pharmacist and practice nurses held regular clinical meeting where issues and learning and development was shared.
• The systems in place to report, investigate and respond to significant events and complaints were comprehensive and there was good evidence the provider complied with the Duty of Candour.
• The practice implemented comprehensive systems to ensure patients were safeguarded from abuse. Staff were trained and there were systems to monitor patients identified at risk of abuse.
• The practice ensured that safe systems were in place for patients referred on the two week pathway and those prescribed high risk medicines. There were care plans in place for vulnerable patients and for those assessed as frail.
• The practice had systems in place to respond to medical emergencies.
• Staff were recruited appropriately. Systems to appraise and develop staff skills and abilities were implemented and feedback from those staff we spoke to felt this was positive and supportive.
• The practice fire risk assessment was not up to date and some fire safety procedures needed improving.
• Governance arrangements to monitor and review the service were implemented and the practice worked closely with the clinical commissioning group to ensure safe and effective service delivery.
• Staff involved and treated patients with compassion, kindness, dignity and respect.

The area where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Maintain minutes of the weekly clinical meetings to provide a record of attendance and an audit trail of items discussed and decisions agreed.
• Review the availability of nurse clinical protocols to support the practice nursing team.
• Update policies and procedures to reflect current legislation and guidance including the recruitment procedure and the complaints procedure.
• Continue to promote the patient participation group for the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by Dr AM Doyle’s Practice for four areas within the key question safe.

We found the practice to be good in providing safe services. Overall, the practice is rated as good.

The practice was inspected on 16 March 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008 (HSCA). At that inspection, the practice was rated ‘good’ overall. However, within the key question safe, four areas were identified as requires improvement, as the practice was not meeting the legislation at that time; Regulation 12 Safe care and treatment HSCA (Regulated Activities) Regulations 2014.

At the inspection in March 2016 we found that:

• The practice had up to date fire risk assessments but regular fire evacuation drills had not been carried out.

• Clinical equipment was checked to ensure it was working properly. However, other non-clinical electrical equipment had either not been safety checked or had not been checked since 2013.

• All clinical staff received annual basic life support training. However, basic life support training or appropriate risk assessments had not been completed for non-clinical staff since March 2014.

• The practice had a secure system to record and keep prescription pads safe but had no system in place to track and monitor the use of loose blank prescription forms.

The practice supplied an action plan and a range of documents which demonstrated they are now meeting the requirements of Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice