We carried out an announced comprehensive inspection at Market Street Health Group on 10 October 2016. The overall rating for the practice was requires improvement. The full comprehensive report published in January 2017 can be found by selecting the ‘all reports’ link for Market Street Health Group on our website at www.cqc.org.uk.

This inspection was an announced focused follow up inspection carried out on 13 February 2018 to confirm that 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 in October 2016.There were breaches in infection control, medicines management and management of patients with long term conditions. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and effective systems in place for recording and reporting significant events.

• The practice carried out regular risk assessments, including health and safety and fire safety.

• There was a process to review Quality Outcomes Framework (QOF) exception reporting rates where the practice was now achieving below the CCG and national averages.

• The practice carried out an infection control audit and had completed the actions identified in it. The practice was clean and tidy and had daily and weekly cleaning schedules in place which were regularly monitored.

• Patient Group Directions (PGD) had been adopted by the practice to allow nurses to administer medicines in line with legislation. PGD’s are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment.

• The practice had good facilities and was well equipped to meet patients’ needs.

• The provider was aware of and complied with the requirements of the duty of candour.

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 Market Street Health Group on 10 October 2016. Overall the practice is rated as requires improvement.

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.
• Improvements were required in the assessment and management of risks to patients.
• 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.
• 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.
• Patients 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Take appropriate steps to address issues around cleanliness and hygiene at the practice.

• Ensure patient group directions (PGDs) which allow nurses to administer medicines in line with legislation are up to date.

• Review its levels of and processes for exception reporting and take all necessary steps to improve outcomes for patients.

The areas where the provider should make improvement are:

• Ensure a safe and clear procedure is in place for patients to follow when providing samples.

• Ensure notices are in place to inform patients about translation/interpreting services available.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice