We carried out an announced comprehensive inspection at Ripley Medical Centre on 10 May 2016. The overall rating for the practice was ‘Good’, but the practice was rated ‘Requires Improvement’ for providing safe services. The full comprehensive report on the May 2016 inspection can be found by selecting the ‘all reports’ link for Ripley Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based follow up review carried out on 28 August 2018 to review actions taken by the practice since our previous inspection in May 2016. This report covers our findings in relation to actions taken by the practice since our last inspection in the area of ‘Safe’ and other areas for improvement which we had identified at the May 2016 inspection.

Overall the practice remains rated as ‘Good’. The practice is now also rated ‘Good’ for providing safe services.

Our key findings were as follows:

• The practice had reviewed their chaperone protocol and consent policy since our last inspection. In addition, all staff who acted as chaperones had been trained and had had their competency to carry out the role assessed to ensure that they were competent to act as chaperones when required to do so.
• The practice had introduced room-specific cleaning schedules and carried out audits to monitor and ensure that cleaning had been undertaken to the required specification.
• The practice had trained all relevant staff in the area of basic life support to ensure staff were competent in this area.
• The practice had reviewed their systems for recalling patients with chronic diseases. The practice had amended their recalls protocol to include telephone calls and text reminders as methods for recalling patients, in addition to contact by letter, to ensure that appropriate efforts were made to recall patients with chronic diseases for review.
• The practice had made a number of changes to improve patient access to appointments. These included improvements to the appointments system and providing extended hours’ appointments on Tuesdays and Thursdays.
• The practice had provided staff with more time for training to ensure that staff completed all mandatory training as identified by the provider.

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 Ripley Medical Centre on 10 May 2016. Overall the practice is rated as good

The practice had recently undergone a change to their management structure. This had changed from a GP Partnership to Derbyshire Community Health Services (DCHS) NHS Foundation Trust from 6 April 2016.

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. Learning from events was applied to enhance the delivery of safe care to patients.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. The practice was committed to staff training and development and the practice team had the skills, knowledge and experience to deliver high quality care and effective treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice responded to feedback received from patients.
• A wide range of literature and information about local services and health-related issues was available in the waiting area.
• Verbal information was provided to patients about how to make a complaint, but there was no information about this on display in the waiting area. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they generally found it easy to make a routine appointment with a GP and appointments were available the same day for all patients through the use of a ‘sit and wait’ system. However, this sometimes meant that patients waited up to two hours.

• The practice ensured they engaged with vulnerable patients to provide them with the support they needed. This included having a more flexible approach to consulting with them to ensure they could receive the care they required.
• The practice had excellent facilities and was well-equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff told us that they felt supported by management.
• The practice reviewed the skill mix of their team to meet their patients’ needs. For example, they had recently appointed an additional full time salaried GP and were actively recruiting an advanced nurse practitioner (ANP)
• The provider had reviewed their contingency arrangements. For example, they were in the process of recruiting bank practice nurse staff to ensure continuity of service during staff leave.
• There was an active patient participation group which worked with the practice for the benefit of patients. For example, they conducted a patient survey following changes to the appointments system.

The areas where the provider should make improvement are:

• The provider should ensure sufficient training and guidance is in place to support staff to understand and fulfil their role as chaperones, including where to stand during an examination.

• The provider should review their delivery of training to enable staff to complete training they deem mandatory within the timescales set.
• The provider should consider increasing the availability of bookable appointments
• The provider should consider reviewing their systems for recalling patients with chronic diseases to include alternative methods of contact.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice