Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 22/06/2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Conran Medical Centre on 27 February 2018.

At this inspection we found:

• The practice had clear 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.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice had an effective programme of continuous clinical and internal audits. The audits demonstrated quality improvements and staff were actively engaged in monitoring and improving patient outcomes as a result.
• The partners encouraged a culture of openness and honesty. The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had an established, proactive patient participation group.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

The practice was –first in the UK to pilot the Lung Health Check (LHC) with The Macmillan Cancer Improvement Partnership. The aim of the pilot was to identify and diagnose lung disease earlier in smokers and former smokers. The one-stop-shop Lung Health check included a CT scan which took place within the mobile clinic. This resulted in one patient being identified and treated within the practice. Due to the success of the pilot this was being rolled out city wide.

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 Conran Medical Centre on 22 June 2015. Overall the practice is rated as good.

We found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also found to be good for providing services for all the population groups that we assess.

Our key findings were as follows:

• The majority of patients we gathered information from on this inspection indicated they were satisfied with the service provided, that they were treated with dignity, respect and care, and that staff were thorough, professional and approachable.
• The practice offered a variety of pre-booked, emergency and on the day appointments, extended opening hours and weekend opening were planned for the near future.
• The practice provided a good standard of care, led by current best practice guidelines, which clinical staff routinely referred to.
• People with conditions such as diabetes, kidney disorders and asthma attended regular clinics to ensure their conditions were appropriately monitored, and were involved in making decisions about their care.
• The practice shared information appropriately with other providers, such as out of hours care providers, to ensure continuity of care to patients.
• The practice had good facilities which were kept safe, and were well equipped to meet patient need.
• The building was clean, and the risk of infection was kept to a minimum by systems such as the use of disposable sterile instruments.
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

The areas where the provider should make improvements are:

• Ensure systems are effective to check and identify when emergency medicines and equipment have reached their expiry date, so that these are disposed of.
• Ensure additional training on the Mental Capacity Act is provided and improve documentation around consent and capacity issues.
• Ensure the recruitment policy is updated to include reference to mandatory pre-employment checks.

We saw areas of outstanding practice including:

• The practice focussed on patients who had recently been bereaved and trained staff to become bereavement champions. We saw specific examples of how patients had benefited from this approach.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We undertook follow a up inspection to Conran Medical Centre on the 8 May 2014.

We did not speak to people who used the service during this inspection.

We found that since our last inspection the registered provider had taken action to ensure that infection control standards were being met. GP consultations rooms, treatment rooms and public areas of the building were clean.

We found that patients, visitors and staff were cared for in a building that was suitably designed and adequately maintained.

We spoke with four people who used the service. They told us they were happy with the service they received. Comments included: "I'm very happy here", "I always see the same doctor so he knows my history", "I feel the doctor takes time to listen to you".

The service had not yet established a patient participation group (PPG). A PPG is made of practice staff and patients that are representative of the practice population. The main aim of the PPG is to ensure that patients are involved in decisions about the range and quality of services provided by the practice. The provider did have some systems in place to take account of people’s views and experiences to improve the quality of the service provided.

All of the consulting and treatment rooms were clean and well maintained. We observed that hand washing facilities were available to promote high standards of infection control. However safe storage and disposal of needles and waste products guidance was not always being followed.

We looked around the building and found that all areas were in a good state of repair. However disabled access, and some health and safety risk assessments had not been carried out by the practice.

We found staffing levels to be adequate within the practice.