Letter from the Chief Inspector of General Practice

On 12th December 2016 we carried out a comprehensive announced inspection at Colchester Medical Practice. We rated the practice as good overall and good for providing effective, caring, responsive and well-led services. We rated the practice as requires improvement for providing safe services and a requirement notice was served. This was because there was not a clear system in place to monitor patients taking high risk medicines.

We identified that there were two areas where the practice should make improvements: we advised that the provider should implement a system to review the health care needs of patients who did not collect their prescriptions and further, in the caring key question, we advised that the provider should offer a carer’s health check.

The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Colchester Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 12th June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 12th December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice continues to be rated as good and safe is now rated as good.

Our key findings were as follows:

• Patients taking high-risk medicines are now monitored through a system of audit, recall and regular checks.
• There were measures in place to identify patients who had not collected their repeat prescriptions.
• Although the provider did not offer a routine carer’s healthcheck, carers were identified on the practice computer systems and referred to the Care Advisor for support and advice.

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 Colchester Medical Practice on 12 December 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 and recording significant events.
• Risks to patients at the premises were assessed and well managed; however, there were not effective procedures in place to monitor patients taking some high risk medicines.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice worked with vulnerable patients to offer them treatment, advice and support, including those who had problems with substance misuse, were homeless or who had experienced domestic violence.
• The practice had suitable facilities and was well equipped to treat patients and meet their needs. Services at the practice included phlebotomy, audiology, ultrasound, a care advisor and a midwife.
• Data from the national GP patient survey reflected that patient satisfaction rates were either comparable or higher for most aspects of care.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from patients, which it acted on.

The areas where the provider must make improvement are:

• Ensure that patients taking high risk medicines are regularly reviewed in line with guidance.

The areas where the provider should make improvement are:

• Offer a carer’s health check.

• Implement a system to review the health care needs of patients who do not collect their prescriptions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Castle Gardens Medical Centre is in Colchester. The practice provides primary medical care to approximately 8,700 people. Castle Gardens Medical Centre is a training practice providing training for GP registrars. These are qualified doctors who wish to pursue a career in general practice.

We carried out an announced inspection on 29 May 2014.

The practice was safe, responsive and effective in meeting the needs of older people. The provider had put in place safeguarding systems which sought to protect vulnerable adults from harm. An advanced nurse practitioner visited larger care homes three times a week.

Improvements were required to ensure that the service was effective for people with long-term conditions.

The practice was safe and effective for mothers, babies, children and young people.

Castle Gardens Medical centre was responsive to the needs of working age people.

Improvements were required to ensure that the practice was caring towards people in vulnerable circumstances who may have poor access to primary care.

The practice was effective and responsive to the needs of people experiencing poor mental health.

The regulated activities we inspected were diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures, and treatment of disease, disorder or injury.

We found that the practice was not meeting all the regulations with which they were required to comply. This was because medicines were not always stored securely and systems were not in place to ensure that vaccines were not stored at the correct temperature. Systems relating to reducing the risk of infection were not fully implemented and systems to monitor quality were unclear.