We carried out an announced comprehensive inspection at Civic Medical Centre on 5 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There was equipment and medicines for use in emergencies and these were checked and documented. Staff were trained in care and treatment of medical emergencies and in how to recognise symptoms when people’s conditions become severe, such as in sepsis.
• Blank prescriptions were logged in and out for use at the practice, however they were left overnight in printers and in unattended rooms.
• Patients received effective care and treatment that met their needs. We saw that clinicians treated and cared for patients in line with current best practice guidelines and legislation.
• The practice understood the needs of its patients’ population and delivered care and treatment tailored to the individual’s needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care. Feedback from patients was consistently positive about care, treatment and access at this practice.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. There was evidence of quality improvement that included audit and which demonstrated outcome improvements. However, there was no formal audit programme based on national, local and service priorities.

Whilst we found no breaches of regulations, the provider should:

• Review the frequency of fire evacuation drills to ensure they are carried out six monthly.
• Review the security of printer prescription pads in the practice to ensure they are safe at all times.
• Implement an audit programme/plan that is based on national, local and practice priorities.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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 Civic Medical Centre on 7 June 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting, recording and analysing significant events.
• Safety alerts were received and acted upon.
• Risks to patients were assessed and well managed.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day and extended appointments for those with enhanced needs.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as a priority. There was a strategy to deliver this vision and it was reviewed in conjunction with stakeholders and staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Staff felt supported by management and were motivated, supervised, felt involved and worked as a team.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Implement a system for monitoring clinical staff’s professional registration status such as with the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC) and their indemnity insurance cover.
• Review staff records to include immunisation status for clinical staff and references are documented.
• Review and update the infection control policies and procedures to include a full range of associated policies and procedures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We found that improvements had been made to the systems in place to assess the suitability of staff for their role and these ensured specified information was now available in respect of people employed.

We found that improvements had been made to ensure safe storage of paper records. Historic paper records were stored securely under a service level agreement and contract with a records management company.

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

“It’s a very good practice”,

“I can’t find fault at all with this practice”,

“It’s fantastic, care is individualised and they have a holistic approach”.

We found that there were suitable systems in place to gain consent from patients. Staff who obtained consent were able to describe the 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.

We found that improvements were needed to the systems in place to assess the suitability of staff for their role and ensure specified information is available in respect of people employed.

We found the provider had effective systems in place for monitoring the quality of services. There was an active Patient Participation Group (PPG), complaints, incidents and significant events were reviewed and they participated in the QOF programme. QOF is a system for the performance management of GPs intended to improve the quality of general practice and reward good practice in surgeries.

We found that improvements were needed to the systems in place to ensure safe storage of paper records at the practice.