This practice is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires Improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those recently retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) - Requires Improvement

We carried out an announced comprehensive inspection at OHP- Leach Heath Medical Centre on 20 December 2017. The practice was previously inspected in February 2016 and was rated as good overall. The practice changed provider in July 2017 and is now being inspected under a new provider registration (Our Health Partnership).

At this inspection we found:

• The practice had experienced difficulties due to redevelopment of the local area and the loss of clinical staff that had placed additional pressures on staff workload.
• The practice had effective systems and processes in place to keep patients safe and safeguarded from abuse. This included safeguarding arrangements for children and vulnerable adults, the management of medicines and infection control. However we identified some weaknesses in recruitment processes.
• The practice did not have effective systems and processes for managing and monitoring risks in relation to health and safety and the premises.
• The practice had established systems for reporting and recording significant events and for learning from them.
• Records seen demonstrated that care and treatment was delivered according to evidence- based guidelines.
• Patient outcomes in relation to the quality outcome framework showed the practice was performing in line with other practices locally and nationally for many long term conditions.
• Practice staff worked with a range of health and care professionals in the delivery of patient care and was proactive in identifying opportunities to promote and support patients to lead healthier lives.
• We found systems for providing staff with ongoing support were inconsistent. This included effective induction and appraisal processes.
• Feedback from patients from the national GP patient survey and the CQC patient comment cards showed that they felt they were treated with compassion, kindness, dignity and respect and felt involved in their care and treatment. Patient satisfaction with consultations with clinical staff and helpfulness of reception staff was comparable to local and national averages.
• Patient feedback on access to appointments was mostly in line with other practices with the exception of ease of access through the telephone system.
• Information about services and how to complain was available to patients. However, complaints were not managed in a consistent way.
• We identified weaknesses in the governance arrangements in the management of some risks and in supporting staff.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure appropriate recruitment checks are in place for all staff employed and where relevant registration with professional bodies are routinely monitored.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care by means of effective systems for the management of risks in relation to the premises (including fire safety, legionella, control of substances hazardous to health and arrangements for business continuity).
• Ensure appropriate provision to ensure staff receive appropriate support, training, supervision and appraisals for the duties they are employed to perform.

The areas where the provider should make improvements are:

• Raise awareness of the Accessible Information Standard so that staff are able to respond to this. Including systems for alerting staff of vulnerable patients so that their needs could be addressed. For example carers and those with specific needs; for example, hearing or sensory difficulties.
• Review medicines for use in an emergency and undertake risk assessment for recommended medicines not routinely stocked.
• Continue to address and improve areas where the practice is an outlier in relation to patient outcomes and prescribing.
• Continue to take action and monitor progress in response to patient feedback regarding telephone access.
• Review system for recording verbal complaints to support learning and improved documentation to ensure complaints are responded to in a consistent and timely way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice