Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at King Edwards medical Centre on 7 October 2015 and rated the practice as requires improvement for the safe key question and good for effective, caring, responsive and well-led. This led to an overall rating of Good. Breaches of legal requirements were found and requirement notices were issued in relation to staffing and fit and proper persons employed. The full comprehensive report can be found by selecting the ‘all reports’ link for King Edwards Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection which we undertook on 22 May 2017 to confirm 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 7 October 2015. At this inspection we found that the requirements of the notices had been met; 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• Clinicians participated in regular clinical audits which were used to modify current practices and demonstrated quality improvement.

• 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.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make 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.
• Staff told us that interpretation services were available for patients who did not have English as a first language, however we saw no notices in the reception areas informing patients this service was available.
• The practice offered a “carers” clinic in association with the local carers association which focused on patients “social prescribing healthcare needs” including loneliness; we noted the practice had identified less than one per cent of its practice list as carers.

The areas where the provider should make improvement are:

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

• Ensure the interpreting/translation services are brought to the attention of patients.

• Review ways of improving childhood immunisation rates.

• Review high exception reporting for diabetes and consider ways to bring this down.

• Ensure patients are provided with up-to-date information on how to access out of hours services.

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 King Edwards Medical Centre on the 7 October 2015. Overall the practice is rated as good.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of safeguarding training for clinical staff and recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• 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 available and easy to understand.
• Patients said there was continuity of care, with urgent appointments available the same day.
• 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 were areas of practice where the provider needs to make improvements.

Importantly the provider must:

• Ensure Level 3 child protection training is provided to all clinical staff.
• Ensure recruitment arrangements include all necessary employment checks for all non-clinical staff.

In addition the provider should:

• Ensure the serial numbers of prescriptions issued are logged and to ensure an audit trail is kept to monitor their use.

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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice