We carried out an announced comprehensive inspection at Parkgate Medical Centre on 27 March 2019 as part of our inspection programme. Our last inspection of the Parkgate Medical Centre was in June 2015 when the practice was rated as Good.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services
• and information from the provider, patients, the public and other organisations.

We have rated this practice as Requires improvement overall.

We rated the practice as requires improvement  for providing safe services because:

• Not all staff had received the appropriate level of safeguarding training or chaperoning training.
• Systems and processes to ensure appropriate standards of cleanliness and hygiene were not adequate. Staff had not had all the required training in infection prevention and control.

We rated the practice as for requires improvement for providing effective services because:

• The practice was unable to show that staff had the skills and knowledge to carry out their roles and there was a lack of evidence staff had received annual appraisals.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as good for providing responsive services because:

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

We rated the practice as requires improvement for providing well-led services because:

• The overall governance arrangements were not always effective in respect of infection prevention and control and staff training.

These areas affected all population groups so we rated all population groups as requires improvement.

The areas where the provider must make improvements are:

• Maintain appropriate standards of hygiene for premises and equipment.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review risks associated with the storage of liquid nitrogen and evidence these have been mitigated.
• Review and improve processes for disposal of sharps bins within the recommended three-month period.
• Review and improve checks of the emergency equipment in line with the Resuscitation Council UK recommendations.
• Review and improve the complaints procedure and information for patients to include information on how to contact the Parliamentary and Health Services Ombudsman (PHSO) to escalate a complaint if not satisfied with the practice response.
• Review and improve the practice's whistle blowing procedure in line with the NHS Improvement Raising Concerns (Whistleblowing) Policy.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkgate medical centre on 9 June 2015. Overall the practice is rated as good.

We found the practice to be good for providing caring, safe, effective, well-led and responsive services. It was also rated as good for providing services for all population groups.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Risks to patients were assessed and managed, including those relating to recruitment checks.

• 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. Complaints would be addressed in a timely manner and the practice endeavoured to resolve complaints to a satisfactory conclusion.

• 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.

• The practice proactively sought feedback from staff and patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice