Letter from the Chief Inspector of General Practice

In March 2015 we found concerns related to the management and prevention of infection, staff receiving appropriate training, test results being processed effectively and care plans for those at risk of hospital admission during a comprehensive inspection of Clarence Medical Centre, Windsor, Berkshire. Following the inspection the provider sent us an action plan detailing how they would implement systems to ensure every member of staff received appropriate role specific training, infection control procedures would be improved, test results would be processed effectively and patient care plans to reduce hospital admissions would be reviewed.

We carried out a desktop review of Clarence Medical Centre on 16 April 2016 to ensure these changes had been implemented and that the service was meeting regulations. Our previous inspection in March 2015 had found a breach of regulations in relation to safe care and treatment. The ratings for the practice have been updated to reflect our findings from this inspection.

We found the practice had made improvements since our last inspection on 10 March 2015 and they were meeting the regulations that had previously been breached.

Specifically the practice was operating effective systems to ensure:

• Formal arrangements were in place to ensure adequate levels of support and training relevant to their staff roles.
• Infection control procedures had been improved. Audits were completed and corrective actions taken as appropriate. The infection control policy had been updated and a documented process had been implemented to monitor cleaning standards.
• Patients care plans to reduce hospital admissions had been reviewed to ensure patients were involved in there development.
• The procedure to monitor test results had been improved to ensure these were reviewed on a daily basis by all the GPs.

We have changed the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe and effective services. The practice was now meeting the regulation that had previously been breached.

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 Clarence Medical Centre on 10 March 2015. Overall the practice is rated as requires improvement.

We found the practice to be good for providing caring, responsive and well-led services. The practice requires improvement in the safe and effective domains. It also requires improvement for all of the six population groups we assessed.

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.
• Communication channels and regular meetings were available to all staff which enabled them to be involved the running of the practice.
• Risks to patients were assessed and well managed. However, infection control guidance was not always followed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Test results may not have been reviewed quickly due to the system used in the practice.
• Staff training was not always identified and monitored to ensure staff could fulfil their roles safely and effectively.
• Patient feedback showed they were treated with compassion, dignity and respect and they were usually involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they sometimes found it difficult to make an appointment with a named GP and that booking an appointment could be hard. The practice had responded to this feedback.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There had a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

There were areas of practice where the provider must make improvements.

• Ensure the role of infection control lead is clearly defined and that the policy is followed, including regular audit and completing any required actions.
• Change the system for receiving test results to ensure any urgent concerns are dealt with promptly.

Additionally the provider should :

• Identify and deliver the training needs of all staff and develop a system to monitor staff awareness and re-training requirements.
• Review the process of designing care plans to reduce the likelihood of unplanned admissions to hospital to ensure patients are involved in the designing of these plans.
• Update information sources for patients to access guidance on how to book advanced appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice