This practice is rated requires improvement overall. (Previous inspection December 2014 was Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Requires Improvement

Are services responsive? – Requires Improvement

Are services well-led? – Requires Improvement

We carried out an announced inspection at Littlebury Medical Centre on 5 April 2018 as part of our inspection programme.

At this inspection we found:

• There was a system in place for reporting and recording significant events.
• Patients were at risk of harm because some systems and processes in place were not effective to keep them safe. For example, patient safety alerts, monitoring of the cold chain, checking of emergency medicines and equipment, sepsis awareness.
• Some of the systems, processes and practices in place to keep people safe and safeguarded from abuse were not effective.
• There were some arrangements for identifying, recording and managing risks but not all had been well managed. For example, fire safety and legionella.
• Most of the medicines management practices in place kept patients safe.
• We saw limited evidence of quality improvement to improve patient outcomes.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Comments cards we reviewed told us that patients said they were treated with compassion, dignity and respect. They felt cared for, supported and listened to.
• Urgent appointments were available on the day they were requested through the triage system.
• The July 2017 national patient survey results had been reviewed but not all had actions in place to improve the areas of concerns identified by the patients registered at the practice.
• There was no overarching governance framework in place to support the delivery of the strategy and good quality care.

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

• Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.
• 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.

The areas where the provider should make improvements are:-

• Ensure that all staff have had an appraisal in the last 12 months
• Continue to monitor the system in place for prescriptions to ensure they are signed before the medicines are dispensed.

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 Littlebury Medical Centre on 4 December 2014.

Overall the practice is rated as good.

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

• Urgent appointments were available the same day.
• The practice had good facilities including disabled access and was found to be clean and tidy.
• Information about services and how to complain was available.
• Patients said they felt the practice offered an excellent service and staff were friendly and caring and treated them with dignity and respect
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles.
• Recruitment checks were carried out and the appropriate recruitment checks had been undertaken prior to employment.
• The practice had a comprehensive business continuity plan in place for major incidents such as power failure or building damage.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

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