Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parklands Medical Practice on 9 August 2016. Overall the practice was rated as good; however a breach of the legal requirements was found which resulted in the practice being as rated as requires improvement for providing safe services.

Following on from the inspection the practice provided us with an action plan detailing evidence of the actions they had taken to meet the standards relating to providing safe services.

We undertook a desk based review on 17 January 2017 and visited the practice on 18 January 2017. This was to review in detail the information the practice had sent to us and to confirm that the practice were now meeting the relevant standards of care.

A full comprehensive report which followed the inspection on 9 August 2016 can be found by selecting ‘all reports’ link for Parklands Medical Practice on our website at www.cqc.org.uk.

The practice is now rated as good for providing safe services.

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

• All Patient Group Directions (PGDs) were signed appropriately by the authorised person as dictated in legislation. PGDs are written instructions to administer medicines to patients, usually in planned circumstances.

• Infection Prevention and Control (IPC) risks were minimised with an appropriate renewal scheme for the disposable curtains.

• Equipment was monitored, maintained and cleaned systematically reducing risks to patients and staff.

• All GPs and the Advanced Nurse Practitioner were trained to child safeguarding to level three.

• All staff had received an appraisal, and planned dates for reappraisal were recorded.

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 Parklands Medical Practice on 09 August 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.

• 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 care and concern and that the GPs and nursing staff were good at involving them in decisions about their care.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs. However, we found that a number of items of equipment which could be used to treat patients were out of date.
• Not all risks to patients were assessed and well managed. We saw that legionella checks had not been undertaken since August 2015 despite a six month renewal date being evidenced.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. However, not all the GPs at the practice were trained to the recommended level three.
• Nursing staff at the practice administered medicines under Patient Group Directions (PGDs). We saw that the PGDs in the practice had not been signed by an authorised person. PGDs are written instructions to administer medicines to patients, usually in planned circumstances.
• The practice could not evidence an infection prevention and control audit on the day of our visit and forwarded this after the inspection. We saw that the disposable curtains used in the practice were dated and last replaced in 2014.
• There was a clear leadership structure. We were told of open and honest communication throughout the team and staff said they felt supported by management. However, we saw evidence that the majority of staff had not received an annual appraisal.
• The practice proactively engaged the Patient Participation Group (PPG) and the Health Champions in the running of the practice. It 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:

The provider must ensure that Patient Group Directions used in the practice are signed by an authorised person as dictated in legislation.

The areas where the provider should make improvement are:

The provider should review the Infection Prevention and Control audit for both sites and make this available for staff to refer to. The practice should also review the renewal regime of the disposable curtains used in the practice and follow best practice.

The provider should review the monitoring of equipment and the systems and processes which are in place and assure themselves that they are able to keep patients and staff safe.

The provider should evidence that all GPs are trained to Safeguarding level three as directed by “Safeguarding Children and Young People: roles and competences for health care staff (2014)”.

The provider should ensure that all staff are provided with an appraisal in a timely manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice