Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Churchill Medical Centre on 2 June 2015. Overall the practice is rated as good. Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services to the six population groups we inspect - People whose circumstances may make them vulnerable, Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); and People experiencing poor mental health (including dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• Staff were aware of the practice’s vision and values and contributed towards them. The practice had achieved an Investors in People award.
• The practice proactively sought feedback from staff and patients, which it acted on. This included creating a specific children’s waiting area.
• The practice has a schedule of audits, which included re-auditing.
• Patients appreciated the flexibility of being able to access services at any one of three sites.
• Parentcraft classes were provided and the cost covered by the practice.
• The practice had some satisfactory Quality Outcome Framework (QOF) outcomes but was below the national average in a number of areas including diabetes and dementia.
• Patient satisfaction with the appointment system and the availability of their preferred GP fell below the Commissioning Contracting Group (CCG) and national averages.
• We found some out of date oxygen masks, although the practice did also have masks that were within their expiry date.

We saw several areas of outstanding practice including:

• The practice had won a NICE (National Institute for Health and Care Excellence) shared learning award in 2014 for its antibiotic prescribing programme which was adopted by the CCG.
• The health care assistants ran a ‘Weigh to go’ exercise and healthy eating class in the evenings and leaflets advertising this were on display in the waiting room.

However there were areas of practice where the provider needs to make improvements. Importantly the provider should:

• Ensure all equipment, including oxygen masks are within their use by date.
• Provide health care assistants with identified clinical supervision.
• Ensure all clinical staff have up to date hepatitis B vaccination.
• Ensure established protocols regarding immunisations are in place, particularly regarding patient specific directions.
• Introduce a cleaning checklist so staff know what has been cleaned and when.
• Ensure that fire emergency action plans are regularly rehearsed, and the fire risk assessment periodically reviewed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice