Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Hampton Medical Centre on 17 March 2016. The practice was rated as requires improvement overall. Breaches of legal requirements were found relating to the Safe and Responsive domains. We carried out a desk-based re-inspection of the practice on 26 January 2017 in order to check that the practice had addressed the breaches of regulation identified at the previous inspection. During this inspection we found that the practice had addressed the issues relating to safety, but that further improvement was required in relation to their responsiveness, and a Requirement Notice was issued in relation to a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

After the focussed inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breaches of regulation 17 (Good governance).

We undertook this further focussed desk-based inspection on 28 September 2017 to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements. You can read the reports from our previous inspections by selecting the ‘all reports’ link for Hampton Medical Centre on our website at www.cqc.org.uk.

Following the focussed inspection in January 2017, we found the practice to be good for providing safe services. The practice had made some improvements in providing responsive services but there remained areas relating to patient satisfaction which had not been fully addressed and therefore they remained rated as requires improvement for providing responsive service but were rated as good overall. Following this further follow-up inspection, they are rated as good for providing responsive services and overall.

Our key findings were as follows:

• The practice continued to improve its NHS GP Patient Survey satisfaction scores in relation to patient access to the service, although in some areas they remained below local and national averages. They had an action plan in place to address areas of low satisfaction.
• The practice was pro-actively trialling ways to make it easier for patients to book appointments and to provide feedback on their experiences.
• The practice actively engaged with the Patient Participation Group and could provide examples of action they had taken in response to the group’s feedback.

The areas where the provider should make improvement are:

• They should continue to review and act on patient feedback in order to further improve patient satisfaction in the service provided.

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 Hampton Medical Centre on 17 March 2016. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and were mostly well managed, however, there were gaps in the monitoring of risks to patients and staff with regards to infection control.

• In most areas staff had the skills, knowledge and experience to deliver effective care and treatment; however, some staff had not received training on infection prevention and control and in the Mental Capacity Act.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance; however, we saw evidence that as a result of an audit, the practice had identified that in some cases prescribing alerts were being ignored, but no action had been taken to address this.
• Patient feedback about their treatment was mixed. Most of the patients we spoke to and most of the CQC comment cards we received were positive about the care received and patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, this did not align with the feedback received from the national GP patient survey, which scored the practice below average for these areas.
• Information about services and how to complain was available, however, some of the information was unclear or misleading.

• Patients we spoke to during the inspection told us that access to a named GP was not always available quickly, which some felt could impact on the continuity of care, but that urgent appointments were usually available the same day; however, the practice was in the process of designing a new appointments system in order to address patients’ concerns about access to GPs.
• 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; however, there was limited evidence of action being taken to address the outcome of the National GP Patient Survey.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The practice was undertaking extensive building works in order to extend and develop their premises and had a clear vision and plans for developing the service provided to the community once the building was complete.

The areas where the provider must make improvement are:

• They must ensure staff receive training in infection prevention and control (IPC), and that staff with specific IPC responsibilities have sufficient time to perform this role.
• They must ensure that newly introduced protocols for the cleaning of clinical equipment are adhered to, and that records are kept to demonstrate this.
• They must ensure that all staff maintain up to date skills and knowledge relevant to their role.

In addition, they should take action to address the following:

• They should ensure that they consider and act on patient feedback.
• They should consider whether computer system prescribing alerts are being adhered to, and take appropriate action to ensure safe prescribing.
• They should advertise the availability of translation services to patients.
• They should ensure that all complaints received are recorded and that they provide patients with complete information regarding the complaints procedure.

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 Hampton Medical Centre on 17 March 2016. The practice was rated as requires improvement overall. Breaches of legal requirements were found relating to the Safe and Responsive domains. After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breaches of regulation 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During the comprehensive inspection we found that the practice had failed to ensure that the risks to patients were being managed with regards to infection control and that the practice had failed to act on patient feedback in order to improve their service. We also identified areas where improvements should be made, which included ensuring that staff were acting on computer system safety alerts, advertising the availability of translation services to patients, and improving their complaints process.

We undertook this focussed desk-based inspection on 26 January 2017 to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Hampton Medical Centre on our website at www.cqc.org.uk.

Following the focussed inspection, we found the practice to be good for providing safe services. The practice had made some improvements in providing responsive services but there remained areas relating to patient satisfaction which had not been fully addressed and therefore they remain rated as requires improvement for providing responsive service. Following the follow-up inspection, they are rated as good overall.

Our key findings were as follows:

• The practice had effective processes in place to control risks relating to infection control. Staff with specific infection control responsibilities had sufficient time resource to perform this role.
• All staff had completed training in order to maintain up to date skills and knowledge relevant to their role.
• The practice had considered patient feedback from the NHS GP Patient Survey, and had plans in place to address areas where they had scored below average. Their achievement relating to patient satisfaction with telephone access to the surgery and the surgery opening hours had improved since the previous inspection, but was still below average. Their achievement for the proportion of patients who said they were able to see the GP of their choice had not improved and remained significantly below average (15% compared to a local and national average of 59%).
• The practice’s computer system displayed prescribing alerts and alerted GPs to combinations of medicines which should not be prescribed together. The practice had an ongoing programme of audit to ensure that their prescribing of these medicines was appropriate.
• The practice had translation services available, and this was advertised to patients in the waiting area.
• The practice recorded both verbal and written complaints received, and provided patients with complete and accurate information about the NHS complaints procedure.

The areas where the provider must make improvement are:

• They must take action to address areas of below average patient satisfaction with the service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice