We previously carried out an announced comprehensive inspection at Bridgnorth Medical Practice on 31 October 2014. The overall rating for the practice was good. The full comprehensive report on the October 2014 inspection can be found by selecting the ‘all reports’ link for Bridgnorth Medical Practice on our website at .

This inspection was an announced comprehensive inspection on 7 November 2018 as part of our inspection programme.

This practice is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

At this inspection we found:

• The practice had systems, processes and practices in place to protect people from potential abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads and contacts for external safeguarding agencies. Clinical staff had received training to the appropriate level for their role but not all non-clinical staff had received safeguarding training.
• There were some systems in place for identifying, assessing and mitigating risks to the health and safety of patients and staff, however further improvement was needed in relation to managing risk.
• The practice had 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. However, we identified one police incident that had not been reported to CQC. The incident did not impact on patient safety or care.
• Patients felt staff treated them with compassion, kindness, dignity and respect.
• Some patients reported difficulties getting an appointment. The practice had taken action to improve access and acknowledged the need to continue to address and improve patient experiences.
• The practice was equipped to treat patients and meet their needs.
• The practice worked closely with outside agencies such as care homes in the local area to improve the care delivered.
• The practice had a culture to report all concerns, complaints and significant events to improve learning.
• Staff had access to training opportunities to equip them in their work. However, not all staff had received essential training.
• The practice had experienced significant staff and recruitment challenges and as a result had reviewed and changed their workforce and staff skill mix to meet the needs of their patient population.
• The practice had a community and care co-ordinator to help assist patients of any age in need of help, support and advice by offering a signposting service and reduce hospital admissions and demand for GP appointments.
• The practice was a teaching practice and registrars were supported in their role and valued by the practice.

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

• Establish effective systems and processes to ensure good governance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Formulate an action plan for responding to the results of the national GP patient survey to include actions to address the lower than average results regarding access to the service.
• Secure the safety of fridge power points to help mitigate the risk of them being turned off.
• Ensure all staff have an annual appraisal of their work to include a review of their job description.
• Improve the monitoring of infection control compliance in between audit cycles.
• Review and update the safeguarding policies in line with latest guidance.
• Ensure notifiable incidents are reported to CQC.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

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

Letter from the Chief Inspector of General Practice

We inspected this service on 31 October 2014 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.

• There were systems in place to keep patients safe from the risk and spread of infection.
• Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.
• The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice