Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Dr C M Thomson and Partners, also known as Meadowside Medical Centre. Our inspection was a planned comprehensive inspection, which took place on 11 December 2014.

The service provided by Dr C M Thomson and Partners is rated as good. On inspection we found that care was safe, effective, well-led and responsive to patients’ needs. All patients we were able to speak to on the day of our inspection told us that the staff at the practice were caring and treated them with dignity and respect.

Our key findings were as follows:

• The practice GPs delivered good evidenced based care and treatment, following recognised best practice. Patient safety was a priority for all clinicians and staff at the practice.
• The practice nurses delivered effective disease management clinics that met the needs of patients.
• The practice was responsive to patient feedback; the reception area was recently altered to ensure telephone conversations between staff and patients could not be overheard.
• The practice was well-led; staff and clinicians consistently reviewed appointment availability to ensure all patients’ needs were met.
• Feedback from patients we spoke to on the day of our inspection told us the practice clinicians were very caring. This was also the view expressed by patients who completed Care Quality Commission comment cards.

There were also areas of practice where the provider could make improvements.

• The practice had a system in place for cascade and sharing of Medical and Healthcare Products Regulatory Agency (MHRA) alerts. However, no one person was given responsibility for leading on this, for example, in co-ordination of patient healthcare reviews and adding these alerts (when appropriate) to the agenda for practice meetings.

Based on the findings of this inspection the practice is rated as good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr C J Studds and Partners (Meadowside Medical Centre) on 9 January 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.

The overall rating for this practice was requires improvement due to concerns in providing safe and well-led services. However, the population groups were rated as good because patients were able to access timely and effective care and treatment.

We rated the practice as requires improvement for providing safe services because:

• There was no documentary evidence to show that the competency of staff trained to carry out extended health care roles was assessed and monitored.
• Patient Specific Directives had not been authorised appropriately.
• The monitoring of the temperatures of vaccine fridges was not effective.
• There was no documentary evidence that showed learning and action taken from incidents had been shared with the whole staff team.

We rated the practice as requires improvement for providing well led services:

• The overall governance arrangements in place were limited and did not support an overview of the performance of the service.
• Policies and procedures were not reviewed to reflect current good practice for example, the infection prevention control policy and safeguarding.
• Training needs were not always being appropriately identified and actioned for example, Mental Capacity Act, health and safety and safeguarding children training.
• There were limited quality assurance systems in place to support service improvement and safety.

We rated the practice as good for providing effective, caring and responsive services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• Care and treatment was delivered in line with standards and evidence-based guidance supported by clear pathways and tools.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

• The areas where the provider should make improvements are:

• Suitable training should be provided to the health and safety lead to ensure the risk assessments meet current legal requirements.
• A system to ensure blank prescriptions held in printers are logged and secured when the practice was closed should be introduced.
• The practice should review how patient electronic information was stored to ensure it is only held on/in patient records.

Chief inspector