Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marine Avenue Medical Centre on 15 December 2015. The overall rating for the practice was good; but was requires improvement for providing safe services.

We carried out an announced focused inspection on 24 August 2017 to review in detail the actions taken by the practice to improve the quality of care. We found action had been taken to address all of the issues identified at the previous inspection. However, we identified an additional concern in relation to the storage of medicines requiring refrigeration.

The reports on the December 2015 and the August 2017 inspections can be found by selecting the ‘all reports’ link for Marine Avenue Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 26 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection in August 2017. This report covers our findings in relation to those requirements.

Overall the practice is rated as good overall and now good for providing safe services.

Our key findings were as follows:

At our previous inspection on 24 August 2017 we said the provider should ensure appropriate arrangements are in place to maintain the cold chain for medicines requiring refrigeration. During this inspection we found that significant progress had been made; comprehensive arrangements had been put into place to address the concerns. This included ensuring that temperatures were recorded each day and putting protocols in place for staff to follow if the temperatures were outside the expected ranges.

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 Marine Avenue Medical Centre on 15 December 2015. The overall rating for the practice was good; but was requires improvement for providing safe services. The full comprehensive report on the December 2015 inspection can be found by selecting the ‘all reports’ link for Marine Avenue Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 24 August 2017 to review in detail the actions taken by the practice to improve the quality of care.

Overall the practice is still rated as good overall but requires improvement for providing safe services.

Our key findings were as follows:

• Action had been taken to address all of the issues identified at the previous inspection.
• Arrangements had been reviewed and processes were in place to report appropriate issues onto the local SIRMS).
• Medicines were all in date and the practice recruitment policy had been updated.
• Infection control audits had been carried out and an action plan to address any improvements identified was in place.
• We identified a concern in relation to the storage of medicines requiring refrigeration.

At our previous inspection on 15 December 2015 we said the provider should strengthen the processes in place to identify and support carers. During this inspection we found that significant progress had been made. There was information on display throughout the practice on the support available for carers. Efforts had been made to identify carers both opportunistically and through various initiatives. This resulted in an increase in the number of carers from 65 at the last inspection to 123 (1.7% of the practice’s list). Plans were in place to continue this work; the patient participation group and some of the practice’s former apprentices were considering ways to do this, including looking at ways to identify and support young carers.

However, we also identified an area of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure care and treatment is provided in a safe way to patients. In particular, ensure appropriate arrangements are in place to maintain the cold chain for medicines requiring refrigeration.

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 Marine Avenue Medical Centre on 16 November 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired), vulnerable people, and people experiencing poor mental health (including dementia) population groups. It required improvement for providing safe services.

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 those relating to checking medicine expiry dates, carrying out a legionella risk assessment and undertaking formal infection control audits.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 we spoke with said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. The practice was able to demonstrate how it was responding to problems experienced by patients in obtaining an appointment.
• 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Review and strengthen the process for checking expiry dates of medicines stored on the premises
• Strengthen the processes currently in place to identify and support carers
• Ensure there is a more formal approach to carrying out and documenting infection control audits which includes a regular review of action points
• Safely secure the cord/chain mechanisms on vertical blinds to reduce the risk of accidental choking for small children

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice