Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Didcot Health Centre Practice on 6 July 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. However, lessons learnt were not always shared with staff quickly and there were inconsistent records of completed actions.
• There was an unreported breach of the cold chain and prescription forms were inconsistently managed.
• 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.
• The majority of patients said they were treated with compassion, dignity and respect. However, not all felt cared for, supported and listened to.
• There was limited support for carers and not all identified carers had a system alert on their medical record to alert GPs and nurses to this.
• 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 did not always find it easy to make an appointment with a named GP although urgent appointments were available the same day.
• 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. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure the cold chain policy for vaccine storage is adhered to.

In addition the provider should:

• Ensure lessons learnt from serious incidents are shared with staff in a timely way and completed actions are recorded.

• Ensure there is a system in place for tracking and monitoring the use of blank prescription forms and pads, in line with national guidance.

• Ensure all medicines for emergencies are stored correctly in accordance with manufacturer’s recommendations.

• Review what active support could be offered to carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our visit to Didcot Health Centre Practice we met with the senior GP partner, the practice manager and a member of the patient participation group (PPG). We spoke with eight patients and with four members of staff.

Patients told us that they received good explanations of their treatment and options for their care. One patient said "today the doctor explained why there was no need to refer me yet. They told me what we could do now and what to expect. The option to refer later is still there".

Patients were treated with regard to their safety and welfare. We saw that patients requiring regular treatment reviews were recalled for these reviews. One patient told us “I get letters reminding me to come in for my regular checks. Just this month I have to come in for an ECG, a blood test and have my blood pressure taken”.

The risk of cross infection was minimised because appropriate guidance had been followed.

Staff were supported on a day to day basis and were able to access training relevant to their roles and responsibilities.

The practice had systems in place to receive and act on patient feedback. Annual satisfaction surveys were carried out and a patient participation group was active. We saw that the practice had recruited another GP to start work in March 2014 in response to patient concerns over access to appointments.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Didcot Health Centre Practice on 6 July 2016. The practice was rated as requires improvement for providing safe services and the overall rating for the practice was good. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Didcot Health Centre Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 10 March 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 6 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had improved their communication of learning and actions taken following significant events. All staff had access to an update on the computer system and “practice education points” were discussed at team meetings.

• The practice had reviewed the cold chain policy, fridge temperature recording and ensured vaccine safety was maximised.

• The practice had reviewed their prescription security protocols to ensure blank prescriptions were securely stored.

• The practice had reviewed the storage of an emergency medicine used to treat low blood sugar. They had ensured it was stored correctly and all staff knew of its location.

The practice had reviewed their carers support and updated their carers’ notice board to highlight areas where support was available. One of the non-clinical staff had undertaken training to support carers and the practice were facilitating the Alzheimer’s support group once per month.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice