We carried out an announced comprehensive inspection at Stockport Medical Group on 15 January 2019 as part of our inspection programme. We rated the practice as requires improvement for providing safe services and good overall.

The full comprehensive report on the January 2019 inspection can be found by selecting the ‘all reports’ link for Stockport Medical Group on our website at www.cqc.org.uk.

At our inspection in January 2019 we rated the practice as requires improvement for providing safe services because:

• The practice did not have safe and effective systems and processes to manage some higher risk medicines.
• The practice did not have an effective recruitment procedure which included recording and retaining all information required by Schedule 3 of the Health and Social Care Act.
• The practice did not have comprehensive risk assessments.
• Records of some staff immunisations were not up to date.

On 19 March 2019, we carried out a focused inspection of the safe key question. We visited the practice to confirm it had carried out the plan to meet the legal requirements in relation to the breaches in regulations identified in our previous inspection on 15 January 2019. This report covers our findings in relation to those requirements.

At this inspection, we found that the provider had satisfactorily addressed all legal requirements.

We have rated this practice as good for providing safe services.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The system for recording the monitoring of patients prescribed higher risk medicines had been much improved.
• The recruitment policy and procedure were improved and met the requirements of Schedule 3 of the Health and Social Care Act.
• Comprehensive risk assessments in relation to fire, buildings and patients had been completed.
• Records of staff immunisations were up to date and there was now management oversight of this.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Stockport Medical Group on 15 January 2019 as part of our inspection programme. At the last inspection conducted in February 2016 we rated the practice as good overall.

Our judgement of the quality of care at this service is based 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.

The practice is rated as

good

overall. We rated the practice as

good

for providing effective, caring, responsive and well-led services.

This means that:

• People who used the service were generally protected from avoidable harm and risk of harm, however management of patient medicines were not always safe, some staff had been recruited without all the required checks being in place.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• Patients were supported, treated with dignity and respect and were involved as partners in their care.
• Patients’ needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
• Safeguarding measures were well embedded, rigorously managed and staff provided excellent examples of interventions.

We rated the practice as

requires improvement

for providing safe services because:

• The practice did not have safe and effective systems and processes to manage some higher risk medicines.
• The practice did not have an effective recruitment procedure which included recording and retaining all information required by Schedule 3 of the Health and Social Care Act.
• The practice did not have comprehensive risk assessments.
• Some staff immunisations were not up to date.

There were areas where the provider must make improvements:

• Ensure care and treatment is provided in a safe way to patients.

There were areas where the provider should make improvements:

• Establish an effective patient participation group.
• Record the reasons for temperatures in practice refrigerators being out of range.

We saw one area of outstanding practice:

• Systems to monitor and identify vulnerable patients who may be at risk of abuse were comprehensive and rigorous.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stockport Medical Group on 17 February 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.
• Information about services and how to complain was available and easy to understand, although the complaints procedure required the additional contact details for the Parliamentary and Health Service Ombudsman.
• Patients said they did not always find it easy to get through to the practice on the telephone but could get an appointment with a named GP and that there was continuity of care. Urgent appointments were available the same day.
• The practice had facilities and equipment 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.
• The practice was open and transparent and apologised when they got something wrong.

We saw two areas of outstanding practice:

• Systems to monitor and identify children who were risk of abuse were rigorous and included detailed searches of past medical history (in case of newly registered families), close scrutiny of data including attendance at Accident and Emergency, and close liaison with health visitors, school nurses and midwifes.
• In 2015 the practice had started using a formula or algorithm (QDiabetes) to identify patients who potentially were at risk of developing diabetes. The search identified over 300 patients and the practice invited those patients with a risk of 50% or more of developing this chronic disease for a review and lifestyle awareness discussion. The practice had now extended this invitation to patients with a potential lower risk of between 10% and 49% for a review.

The areas where the provider should make improvement are:

• Ensure a periodic analysis of complaints and significant events is carried out to identify themes and trends so that appropriate action can be taken as required.
• Ensure second cycle audits are undertaken in a timely manner.
• Ensure the staff training matrix includes a record of GP mandatory training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice