Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Medina Healthcare on 13 December 2016 to check that action had been taken since our previous inspection in March 2015.

Overall the practice was rated as good. At our previous inspection, the practice was rated good for Effective, Caring, Responsive and Well Led services.

However, the practice was rated as requires improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services.

At our previous inspection, we found that the practice had not ensured that procedures for the management of infection control included; an annual infection control statement, a completed audit of the premises and a risk assessment and policy for the management of Legionella. Also there was no system in place to monitor the cleaning of carpets and privacy curtains.

We inspected the practice on 13 December 2016 to check that they had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Medina Healthcare on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

• Curtains had been replaced or regularly cleaned in all treatment and consultation rooms.
• Carpets had been steam cleaned bi-annually.
• A Legionella risk assessment had taken place on 31st July 2015 and all actions completed.
• An infection control audit had been undertaken and a training programme for new and existing staff had been instigated.

The practice is now rated good for Safe services.

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 Medina Healthcare on 26 March 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, people whose circumstances may make them vulnerable and people experiencing poor mental health. It required improvement for providing safe services.

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

• Risks to patients were assessed and well managed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• 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 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 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 was visibly clean and there were systems in place to maintain an appropriate standard of cleanliness and hygiene.

• The practice was rated highly by patients for the respect they were shown and for the kindness and consideration shown by reception staff.

• The practice provided GP appointments at times that met the needs of their patients with same day appointments or telephone consultations. Some appointments were available until 6.45pm for patients who could not attend during working hours.

• The latest GP patient survey showed that 93% of the patients that responded rated their overall experience of the practice as good or very good.

• The practice GPs met with other health professionals every month to keep each other informed of any safeguarding issues or vulnerable patients.

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

Importantly the provider must;

• Ensure that procedures for the management of infection control include; an annual infection control statement, a complete audit of the premises and a risk assessment and policy for the management of Legionella. Also that a system is in place to monitor the cleaning of carpets and privacy curtains.

In addition the provider should;

• Ensure staff have the opportunity to update their training in subjects such as information governance, equality and diversity and fire safety within the timescales set by the practice as mandatory.

• Ensure that regular clinical audit cycles are re-established to demonstrate change and improvements made.

• Although complaints were shared with staff groups involved there was no recorded forum for discussion to show that all complaints had been openly shared for learning.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice