We carried out an announced comprehensive inspection at Ford Medical Practice on 10 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.

We have rated this practice as requires improvement overall. We rated the practice as requires improvement for the population group families, children and young people and good for the remaining population groups.

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

• The practice did not have appropriate systems and processes in place for safeguarding children.
• A number of health and safety related checks were not being followed as required.
• Staff recruitment and selection practices were not always sufficiently robust.
• There was no system to ensure histology results were received for patients following minor surgery.

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

• The overall governance arrangements were not fully effective.
• We saw little evidence of systems and processes for checking on areas of practice such as safeguarding, staff training, the provision of minor surgery, the management of safety alerts, security of prescriptions and staff recruitment practices.

We rated the practice as good for providing effective services because:

• There were patients received effective care and treatment that met their needs.
• The practice organised and delivered services to meet patients’ needs.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as good for providing responsive services because:

• The practice organised and delivered services to meet patients’ needs.
• Patients could access care and treatment in a timely way.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure patients are protected from abuse and improper treatment.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training and professional development, necessary to enable them to carry out their duties.

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

The areas where the provider should make improvements are:

• Develop a programme of clinical audit including audits linked to the provision of minor surgery.
• Ensure staff training records are kept up to date and that an oversight of staff training is maintained at provider level.
• Ensure the process for making a complaint is well publicised for patients and that all complaints are managed within the provider’s policy and procedure.
• Ensure an appropriate system is in place for the management and control of hand written prescription forms in line with national guidance.
• Provide reception staff with information and guidance specific to the symptoms of sepsis.
• Review the system in place for managing patient safety alerts to evidence that appropriate action is taken in response to all relevant alerts.
• Introduce a system to audit how consent to treatment is gained.
• The practice should engage with a representative sample of the patient population through the formation of a Patient Participtation Group (PPG).

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice.

Letter from the Chief Inspector of General Practice

This is the report from our inspection of Ford Medical Practice. Ford Medical Practice is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection on the 11 November 2014 at Ford Medical Practice. We reviewed information we held about the services and spoke with patients, GPs, and staff.

The practice was rated as Good overall.

Our key findings were as follows:

• There were systems in place to mitigate safety risks. The premises were clean and tidy. Systems were in place to ensure medication including vaccines were appropriately stored and in date.

• Patients had their needs assessed in line with current guidance and the practice promoted health education to empower patients to live healthier lives.

• Feedback from patients and observations throughout our inspection highlighted the staff were kind, caring and helpful.

• The practice was responsive and acted on patient complaints and feedback.

• The practice was well led. The staff worked well together as a team and had regular staff meetings and training.

We saw an area of outstanding practice:

The practice was responsive to the needs of older and vulnerable people. The practice offered an enhanced service by offering health checks carried out by the health care assistant or a practice nurse in the community for patients living independently and in residential and nursing homes. This was to promote good health and to monitor chronic and acute conditions. A review of this service indicated that unplanned admissions to hospitals had been reduced.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice