Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ongar War Memorial Medical Centre on 8 March 2016. 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 the skills, knowledge and experience to deliver effective care and treatment.
• The majority of 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients said they found it was very difficult to make appointments with both a named GP and for same day appointments. Patients told us that there was limited continuity of care.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient forum. For example, they had piloted ‘sit and wait’ clinic to try to solve appointment issues and sought patient feedback on the outcome. The provision of services was then changed in response to their feedback.
• 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 complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Consider obtaining children’s pads for the defibrillator.
• Improve the identification of patients who are carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

At our previous inspection in September 2014 we found the provider did not have sufficient procedures in place to assess the risk of and prevent, detect and control the spread of healthcare associated infection. The practice did not have systems in place to ensure the maintenance of appropriate standards of cleanliness and hygiene.

At this inspection, we found that improvements had been made and that patients, staff and other visitors were protected from the risks of acquiring an infection by introducing systems and standards of cleanliness. The infection control lead had undergone specialist training and implemented a policy and guidance for infection, prevention and control. This was implemented immediately after our initial inspection and this identified roles within the practice for clinical and non-clinical leads.

We observed the premises to be clean and tidy. We saw there were cleaning schedules in place and cleaning records were kept. We discussed the training, supervision and audits with the lead for environmental cleaning. They informed us that all cleaning training and schedules were kept by them and the practice manager completed spot checks or informed them if any member of staff identified an area of cleaning had not been completed. We saw that this was dealt with on the same day by viewing the log of actions they kept.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We conducted a follow up inspection to look at the cleanliness and management of infection control within the practice and how staff were supported to perform their roles and deliver safe and effective care and treatment. The provider had submitted an action plan stating they would be compliant by June 2014.

We found an infection prevention control audit had been conducted by the practice. It identified areas requiring further attention but was not supported by an action plan, allocating responsibilities to staff and detailing when issues were required to be resolved.

We found the infection prevention control lead had not received training. There were also no completed general or specific surgical cleaning schedules to demonstrate where rooms and equipment had been cleaned and whether this had been effective.

A supervision policy had been introduced for staff. The practice manager told us staff were receiving regular one to one meetings with their manager. However these meetings did not assess the performance of individual staff members. This was contrary to the guidance issued in the provider’s own supervision policy. Clinical staff received one to one supervision and also benefitted from additional clinical supervision. They told us they appreciated this opportunity to reflect on their performance and found it very useful.