Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Egremont Medical Centre -JJM Hickey on 24 June 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the 24 June 2016 inspection can be found by selecting the ‘all reports’ link for Egremont Medical Centre -JJM Hickey on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 23 February 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 24 June 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 addressed the issues identified during the previous inspection. Appropriate recruitment checks were in place for GP locums including Disclosure and Barring Service (DBS) checks.
• There were systems in place to ensure non-clinical complaints were appropriately investigated and acted upon.

In addition, the practice had made the following improvements:

• A system was in place to report and analyse incidents to identify any trends.
• The cleaning of the premises was monitored.
• Safeguarding training for all staff had been completed.
• The safety and quality of patient care was monitored within clinical meetings.

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 Egremont Medical Centre on 24 June 2016. Overall the practice is rated as requires improvement.

The practice has dealt with significant challenges in the last six months, including the loss of clinical staff and the recruitment of salaried GPs and practice nurses. The practice identified a number of systems and processes that require improvement to ensure the practice effectively meets the needs of their patients.

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 were assessed and well 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was not easily available. There was evidence that improvements were made to the quality of care as a result of clinical complaints and concerns.
• Patients said they found it easy to make an appointment and to get an appointment with a named GP and there was continuity of care, with urgent appointments 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.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that the practice can demonstrate they have carried out appropriate recruitment checks on locum GPs to promote and maintain patients’ safety.

• Ensure non-clinical complaints are appropriately investigated and any learning and actions carried out are shared across the practice team.

In addition the provider should:

• Support non-clinical staff to identify and report incidents that affect the safety or quality of the service provided.

• A system should be introduced to review significant events to ensure actions are embedded and any trends identified.

• A system should be put in place to monitor the cleaning undertaken by the external cleaning company responsible for the cleaning of the premises including clinical areas.

• The practice should review the content of clinical meetings to ensure key areas that monitor patient safety and quality of the service provided are regularly discussed.

• The practice should ensure all non-clinical staff have received safeguarding training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Our inspection of 22nd January 2014 found that improvements were needed to the staff recruitment procedure and practices to ensure patients received care and treatment from staff who were suitable for their role. We carried out this visit to ensure these improvements had been made. We found that overall appropriate action had been taken.

We found that patients were satisfied with the service provided at the practice. Comments made included:

“All treatment is explained from start to finish and feedback is there for you”,

“We come to get looked after and we get looked after”,

“It’s excellent; the doctors are approachable as are the reception staff”.

We found that there were suitable systems in place to gain consent from the patients. Staff who obtained consent were able to describe the consent process for both formal and informal consent. Staff demonstrated knowledge and understanding in the safeguarding of vulnerable adults and children.

We found that patients care and treatment was assessed, planned and delivered in order to meet their needs. Care and treatment plans were documented and reviewed and patients were fully informed and involved in their care or treatment.

We found that improvements were needed to the systems in place to assess the suitability of staff for their role and to ensure specified information was available in respect of people employed.

We found the provider had an effective complaints process in place and complaints were responded to appropriately.