This practice is rated as Good overall. (Previous rating November 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at Hollow Way Medical Centre on 26 November 2018. This inspection was carried out as part of our inspection programme.

At this inspection we found:

• The practice had inconsistent systems in place to manage risk. For example, the system to review test results was not always operated effectively. However, when safety incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It monitored that care and treatment was delivered according to evidence based guidelines.
• Governance processes were not always carried out effectively. The practice had not identified shortfalls in identifying, assessing and managing risks in some areas of activity.
• Systems for the management of medicines were mostly operated effectively.
• Staff treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice hosted a wide range of services to support patients social and psychological needs in addition to their health needs.
• The practice recognised the needs of their multi ethnic population.
• There was a strong commitment to continuity of care with patients encouraged to see and consult with their GP of choice.
• There was a focus on continuous learning and improvement at all levels of the organisation.

The area where the provider must make improvement is:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hollow Way Medical Centre on 25 November 2015. Overall the practice is rated as good.

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 the skills, knowledge and experience to deliver effective care and treatment.
• Patient care was effectively monitored in order to drive improvement.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The diverse needs of the patient population were considered in the planning and delivery of the service.
• Information about services and how to complain was available and easy to understand.
• Patients’ satisfaction in the appointment system was higher than other practices in the locality. 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.

.

We saw areas of outstanding practice:

• The practice went beyond usual working relationships with other organisations and this enabled it to provide holistic care and treatment for patients who were vulnerable. For example:

  • We saw evidence that GPs had been actively involved with other statutory partners in preventing harm to patients, beyond the expected role of clinicians. There were examples of GPs being involved in helping patients manage difficult social situations.
  • The practice cared for patients who suffered from substance misuse or alcohol problems and two GPs had specialist skills in this area. They worked with a local charity that supported patients with addictions. This enabled them to develop care and treatment planning for this group of patients. Staff worked with a local employment service which aimed to provide employment experience and training to patients with drug and alcohol problems and mental health conditions. In the previous two months two patients were supported in their applications to work at the charity and GPs had provided them with references

However there were areas of practice where the provider should make improvements:

• Review staff training to ensure that reception staff fully understand the role of chaperoning.
• Ensure nurses have an adequate guidance to follow in regards the Mental Capacity Act 2005.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Hollow Way Medical Centre provides primary medical services to patients from Cowley and the surrounding area. The practice does not provide out of hours care from the practice but has arrangements for this service to be delivered by a dedicated out of hours provider. Information for patients on how to contact out of hours services is displayed at the practice and on their website. It is also included in the answer machine message for patients who telephone the practice out of hours.

During this inspection we spoke with patients, members of the patient reference group and staff including GPs, the practice manager, nurses and receptionists.

Services at Hollow Way Medical Centre were delivered safely and there were systems to monitor, maintain and improve safety. Sufficient numbers of staff with the skills and experience required to meet patients’ needs were employed and there was enough equipment to enable staff to care for patients. Staff followed best practice guidance and worked with other services to deliver effective care to patients. The practice was caring and treated patients with dignity and respect. Patients’ privacy was maintained and support provided in order for them to make informed choices about the care they wished to receive. The practice was responsive to individual needs of patients and access to services was facilitated in a wide variety of ways. There was a clear leadership structure with an open culture that adopted a team approach to the welfare of patients and staff. The practice took into account the views of patients and those close to them as well as engaging staff when planning and delivering services.

Patients over the age of 75 had been allocated a dedicated GP to oversee their individual care and treatment requirements delivered in the practice or in the patient’s own home.

Mothers, babies, children and young people had access to dedicated specialised staff as well as dedicated clinics and health promotion materials.

The practice made provision for the working-age population and those recently retired with some evening appointments and Saturday influenza innoculation clinics as well as telephone consultations.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.