Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Practice on 11 July 2016. The practice was rated good for effective, caring, responsive and well-led domains, and was rated requires improvement for the safe domain. The overall rating for the practice was good. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Parkside Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 11July 2016. This report covers our findings in relation to those requirements.

At our previous inspection on 11 July 2016, we rated the practice as requires improvement for providing safe services as the chaperone policy was not fully risk assessed by the practice. In addition, recruitment processes were lacking clearly documented evidence around records to demonstrate full former employment checks had been completed for all employees.

It was also noted on the previous inspection that the treatment room and medicines fridge were not always known to be securely locked. In addition the practice was advised that it should do more to increase support to patients with mental health needs.

Our key findings from our inspection on 31 May 2017:

• The practice had now implemented comprehensive employment checks with relation to the employment of locum GPs and all new staff.
• Staff had been risk assessed for chaperone duties and correctly trained.
• There was an increase in security for medicines and confidential information.
• Vulnerable mental health patients who were not attending for annual review (after three invitations to do so) were being personally telephoned by their named GP for welfare checks and invited again to attend the practice.
• The practice had sought support from the local clinical commissioning group (CCG) and local medical committee (LMC) to assess and facilitate changes to the practice management. A new manager had been recruited to oversee these changes and to work with the practice to continue to improve the general management and structure of the practice.
• The patient participation group was providing support to the patient engagement meetings facilitated by the CCG and was producing an informative quarterly newsletter for all patients.
• The practice was proactively looking at new ways of working in the future with other local providers to improve patient care.
• The practice was currently reviewing the appointment booking system in order to provide a greater balance between pre-bookable and open access appointments without the need to increase the staffing levels.
• There was a targeted programme using social media to engage with younger patients and to keep them supplied with relevant health information.

The practice is now rated as good for providing 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 Parkside Practice on 11 July 2016. The practice was rated good for effective, caring, responsive and well-led domains, and was rated requires improvement for the safe domain. The overall rating for the practice was good. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Parkside Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 11July 2016. This report covers our findings in relation to those requirements.

At our previous inspection on 11 July 2016, we rated the practice as requires improvement for providing safe services as the chaperone policy was not fully risk assessed by the practice. In addition, recruitment processes were lacking clearly documented evidence around records to demonstrate full former employment checks had been completed for all employees.

It was also noted on the previous inspection that the treatment room and medicines fridge were not always known to be securely locked. In addition the practice was advised that it should do more to increase support to patients with mental health needs.

Our key findings from our inspection on 31 May 2017:

• The practice had now implemented comprehensive employment checks with relation to the employment of locum GPs and all new staff.
• Staff had been risk assessed for chaperone duties and correctly trained.
• There was an increase in security for medicines and confidential information.
• Vulnerable mental health patients who were not attending for annual review (after three invitations to do so) were being personally telephoned by their named GP for welfare checks and invited again to attend the practice.
• The practice had sought support from the local clinical commissioning group (CCG) and local medical committee (LMC) to assess and facilitate changes to the practice management. A new manager had been recruited to oversee these changes and to work with the practice to continue to improve the general management and structure of the practice.
• The patient participation group was providing support to the patient engagement meetings facilitated by the CCG and was producing an informative quarterly newsletter for all patients.
• The practice was proactively looking at new ways of working in the future with other local providers to improve patient care.
• The practice was currently reviewing the appointment booking system in order to provide a greater balance between pre-bookable and open access appointments without the need to increase the staffing levels.
• There was a targeted programme using social media to engage with younger patients and to keep them supplied with relevant health information.

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with eight patients, seven members of staff (including four GPs) and reviewed records in relation to four patients. The practice operated from two surgeries a few miles apart serving two communities totalling approximately 11,500 patients.

Patients were happy with the care provided. One patient told us that the GP had been “very thorough” and another said; “The doctor was lovely today.” Several commented that they had been advised by the GP to call back if they were concerned about anything.

There were effective systems in place to reduce the risk and spread of infection. During our inspection we observed that the surgery was clean. We saw that offices and clinical rooms were clean, surfaces, trolleys and couches, curtains, curtain rails and the tops of cupboards were all clean.

Medicines which were stored on the premises were kept safely in a locked cabinet and audited on a monthly basis. The medicines which were required for doctors bags when visiting patients were checked monthly by the deputy practice manager to ensure they remained in date.

We reviewed staff files for two GPs employed by the practice. We saw proof that they were registered with the General Medical Council (GMC), had appropriate medical protection insurance and were on the primary medical performers list.

The practice reviewed the progress of the Quality Outcomes Framework (QOF) on a regular basis. The QOF gives an overall indication of the achievement of a practice through a points system. As a result a chronic obstructive pulmonary disease (COPD) audit had been carried out. Measures logged before and after the audit showed that outcomes in every aspect of COPD care had improved.