Fairfield Medical Centre was previously inspected in May and August 2015 and was rated good overall and in all domains.

At this inspection in June 2018 the practice is rated as Good overall.

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

We carried out an announced comprehensive inspection at Fairfield Medical Centre on 28 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

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 used their knowledge of the local community and patient population to deliver high quality and person centred care.
• 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.
• There was a strong focus on improvement at all levels of the organisation.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff were supported with personal development and training. They received regular appraisals.
• Data from the Quality and Outcomes Framework (QOF) showed the results for practice management of patients with long-term conditions were good.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Patients said they were able to book an appointment that suited their needs. Pre-bookable, on the day appointments and home visits were available. Urgent appointments for those with enhanced needs were also provided the same day.
• The practice was equipped to treat patients and meet their needs.

The areas where the provider should make improvements are:

• Continue to review ways to increase uptake for cervical screening.

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 of this practice on 12 May 2015. Breaches of legal requirements were found during that inspection within the safe domain. After the comprehensive inspection, the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:

• Ensure that all recruitment checks are carried out and recorded as part of the staff recruitment process. Ensure there is a written risk assessment where decisions have been made regarding staff not receiving a criminal record check via the Disclosure and Barring Services (DBS)
• Ensure that an infection control audit is completed on a regular basis and any actions recorded and updated. Complete a risk assessment for the control of substances hazardous to health (COSHH) and ensure that a risk assessment for legionella is completed.

We undertook this focused inspection on 17 August 2015 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

Our key findings across the areas we inspected were as follows:-

• All required recruitment checks were carried out and recorded. There was a written risk assessment in relation to which staff should have a criminal record check via the Disclosure and Barring Services (DBS)
• An infection control audit had been completed and actions from the audit had been recorded. This was to be discussed at the quarterly management meeting. We noted that there were risk assessments for the control of substances hazardous to health (COSHH). The practice had also completed a recent legionella risk assessment and had a supporting policy in place.

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 Dr Evans and Partners (also known as Fairfield Medical Centre) on 12 May 2015. Overall the practice is rated as good.

Dr Evans and Partners provides personal medical services to people living in the Leatherhead area. At the time of our inspection there were approximately 10,500 patients registered at the practice with a team of five GP partners. The practice was also supported by salaried GPs, GPs in training, a practice nurse, phlebotomist, a team of reception and administrative staff, an assistant practice manager and a practice manager

We visited the practice location at Fairfield Medical Centre, Lower Road, Great Bookham, Leatherhead, Surrey, KT23 4DH.

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. There was a culture of openness and transparency within the practice and staff told us they felt supported. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

Our key findings were as follows:

• Staff understood their responsibilities to raise concerns, and to report incidents and near misses.
• Information about safety was recorded, monitored, reviewed and addressed.

• Risks to patients were assessed and well managed
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients told us they did not always find it easy to make an appointment or have appointments with their named GP however they had been able to access urgent appointments on the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.

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

Importantly, the provider must:

• Ensure that all recruitment checks are carried out and recorded as part of the staff recruitment process. Ensure there is a written risk assessment where decisions have been made regarding staff not receiving a criminal record check via the Disclosure and Barring Services (DBS)
• Ensure that an infection control audit is completed on a regular basis and any actions recorded and updated. Complete a risk assessment for the control of substances hazardous to health (COSHH) and ensure that a risk assessment for legionella is completed.

In addition the provider should:

• Ensure that complaints information is clearly displayed.
• Improve the quality of record keeping to ensure that actions from significant events are clearly evidenced.
• Ensure there is a readily available business continuity plan for staff to follow.
• Ensure that staff have a date for outstanding appraisals.
• Continue to review and implement improvements to patients’ access to the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice