Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Malling Health @ Foleshill on 10 January 2017. As a result of our inspection the practice was rated as good overall but required improvement for providing caring services. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Malling Health @ Foleshill on our website at www.cqc.org.uk.

This inspection was a desk-based focused inspection carried out on 7 November 2017 to confirm that the practice had carried out their plan to meet the improvements that we identified at our previous inspection on 10 January 2017. This report covers our findings in relation to those improvements.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice had continued with their recruitment of clinical staff programme and had successfully recruited an additional practice nurse and a salaried GP (40 hours) who was due to commence at the practice on 20 November 2017.
• Action had been taken in response to patient feedback from the National GP Patient Surveys. This included: practice surveys to obtain patients views on their experiences of the services received; patients’ access to appointments, telephone and translation service availability had been kept under review; the installation of additional telephone lines to ease telephone access; and clinical hours had been increased (by 10 hours) to improve consultation time. The practice had achieved a score of 69% for telephone access which compared with the local and national averages of 71%. This was an improvement on the previous years’ score of 46%.
• Data from the National GP Patient Survey published July 2017 showed that improvements had been achieved in how patients rated the practice for several aspects of care. Results were generally above or in line with the local and national averages. For example, 87% of patients said the GP gave them enough time, compared to the Clinical Commissioning Group (CCG) average of 85% and the national average of 86%; and 89% of patients said the last GP they saw or spoke to was good at involving them in decisions about their care, compared to the CCG average of 80% and the national average of 82%.
• The practice had been more proactive with identifying carers and as a result had seen increases in the number of patients with caring responsibilities on their register. There were now 45 carers (previously 20) on the register who could receive support and advice from the practice. This represented 1.4% of the patient population.
• The chaperone procedures for all staff had been reviewed and updated.
• Details on how to complain and the full address of the Parliamentary and Health Service Ombudsman (PHSO) had been added to the practice leaflet so that patients would know who they could contact if needed.

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 Malling Health @ Foleshill on 10 January 2017. 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.
• The practice was part of Integrated Medical Holdings (IMH) LTD organisation. Clinical staff and the practice manager worked across two separate sites.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. All events were reported into a central system.
• Staff had the skills, knowledge and experience to deliver effective care and treatment. Clinical staff told us workloads were high which increased pressure on staff.
• Some patients told us they found the appointment system difficult to access. Same day appointments were available . Patients were offered the extended hours scheme between 6.30pm and 9.30pm.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns. A complaints leaflet was available on request, but details on how to complain were not included in the practice leaflet.
• The practice had good facilities and was well equipped to treat patients and meet their needs and complied with the Disability Discrimination Act (DDA) standards.
• Integrated Medical Holdings (IMH) LTD organisation had a clear leadership structure and governance framework. Staff told us they had little contact with senior managers from the organisation, but felt supported by the senior team within the practice.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Continue the programme of recruitment of clinical staff to augment the clinical team, whilst maintaining clinical capacity and support to front line staff.
• Review the chaperone procedures for all staff.
• Add details on how to complain into their practice leaflet and include the full address of the Parliamentary and Health Service Ombudsman( PHSO).
• Develop an action plan to review and maintain patient’s access to appointments, telephone and translation service availability.
• More proactively identify carers.
• Continue to look at ways to improve patient satisfaction rates.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice