Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by St Gabriel’s Medical Centre for one area within the key question safe.

We now found the practice to be rated as good in providing safe services. Overall, the practice is rated as good.

The practice was previously inspected on 21 May 2015. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection, the practice was rated good overall. However, within the key question safe, one area was identified as requiring improvement, as the practice was not meeting the legislation at that time:

Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed

We found that the registered person did  not operate robust recruitment procedures to ensure they only employed fit and proper staff. This was in breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• Disclosure and Barring Service (DBS) checks had not been sought for all appropriate staff members.

The practice has submitted to the CQC, a range of documents which demonstrate they are now meeting the requirements of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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 St Gabriel’s Medical Centre on 21 May 2015. The practice had previously been inspection in October 2013 using CQC’s previous inspection methodology.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It required improvement for providing safe services.

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 and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of 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.
• Patients said they were treated with dignity and respect.
• 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.
• 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.
• There was a higher than average number of children registered at the practice and the GPs visited the local Sure Start Children’s Centre at least once a month to make sure needs were identified and met.

We saw an area of outstanding practice:

• The practice had started to offer consultations by email for some patients as a pilot. This was in response to patients saying it was difficult to access appointments.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider must:

• Ensure that recruitment arrangements include all necessary employment checks for all staff.

Also the provider should:

• Carry out further surveys looking at appointment availability and patients’ satisfaction with the appointment availability.
• Improve clinical audit cycles and formalise reviews of procedures such as joint injections so improvement can be evidenced.
• Consider increasing the number of patient participation group (PPG) members so views are more reflective of the patient population.
• Provide management support and appraisals for the practice manager.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with the practice manager, a doctor and two reception staff. We also spoke with five patients.

Patients told us they were treated respectfully by staff and were given enough privacy. They spoke positively about the doctors and other staff. Patients told us they sometimes found it difficult to get appointments at times that were convenient to them.

Emergency drugs and equipment was available for use in a medical emergency and all staff had been trained in basic life support.

We saw that all areas of the practice were clean. Protective clothing such as disposable gloves were available and liquid hand wash, alcohol hand gel and paper towels were available in all consultation rooms.

The practice had a recruitment policy in place and appropriate checks were carried out prior to new staff starting work.

A patient survey was carried out annually by the practice. A patient participation group (PPG) was involved in the survey. All complaints were recorded and any themes were discussed with a view to improvements being made.

We carried out an announced comprehensive inspection at St Gabriel’s Medical Practice

on 18 February 2019 as part of our inspection programme.

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 good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Carry out a risk assessment to identify a list of medicines that are not suitable for a practice to stock and ensure this is kept under review.
• Ensure prescriptions are stored securely.
• Improve children’s immunisation rates.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice