Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manor Park Medical Centre on 12 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice was engaged in an initiative to improve outcomes for over 75 year olds who might be frail, lonely and isolated.
• 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.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Take steps to reduce exception reporting rates in quality and outcomes framework in areas where they are higher than average. For example, for patients with poor mental health and patients with dementia.

• Increase the percentage of women aged 25 to 64 whose notes record that a cervical screening test has been performed in the preceding five years.

• Ensure safety alerts are actioned appropriately.

• Ensure all staff receive appropriate training on the Mental Capacity Act 2005 and consent.

• Ensure all electrical equipment is stored securely and safely.

• Improve tracking for the use of prescription stationery.

• Continue to improve patients’ satisfaction with access to the practice by phone.

• Build on the work undertaken so far to identify carers within the practice in order to increase the number of carers known to the practice and help ensure they receive appropriate support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

At our last inspection on 17 January 2014 we found that the provider was non-compliant in two of the outcome areas. This was because not all government guidance had been followed in relation to infection control. We also found that the practice had not undertaken all appropriate checks to ensure staff were of good character before they started work.

We asked the provider to send us an action plan outlining the steps they planned to take in order to meet the regulations. This was received on 20 February 2014.

During this inspection we spoke with the practice manager and the lead practice nurse for infection control. We reviewed the practice’s documentation in relation to infection control. We also looked at staff training and recruitment records.

We found that the practice had an up to date infection control policy in place and arrangements in place to ensure that it was implemented. We also saw evidence that all staff had up to date training in this area.

We found that the practice had arrangements in place to ensure that the information required for workers engaged in a regulated activity as set out in Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 was obtained prior to employment.

We spoke with six patients at the surgery and received written comments from another. We spoke with the practice manager, two receptionist and two General Practitioners (GP’s) and a nurse. We observed the medical centre in operation and looked at policies and records to help us understand how the practice was run. At this inspection we focussed on the main surgery and did not visit the branch surgery.

We found that patients were involved in their care and the running of the surgery. A patient said, “The doctor does listen. They explain things very clearly. What the first steps are going to be and the steps after that.” The practice runs a web-based patient participation group. A patient told us, “They are definitely trying through the email to improve communication and getting views about the practice.”

We saw that patients’ records supported safe and effective clinical care. There were systems for managing patients’ medicines safely and for ensuring investigation results were followed up. Patients expressed confidence in their care with one commenting, “I have never needed to chase my doctor, I have always been able to get medical care and attention when required, and I know that my family is fully supported.”

We found that patients were seen and treated in a clean and hygienic environment. However, patients were not fully protected from the risk of infection as not all government guidance had been followed.

We found that not all appropriate checks were carried before people started work to ensure they were of good character.

There were arrangements in place to assess and monitor the quality of service provided. We found changes were made in light of complaints and critical incidents.