Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stockwood Medical Centre on 16 December 2015. Overall the practice was rated as good with requires improvement for the safe domain. Following the inspection we issued a requirement notice. The notice was issued due to a breach of Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, Safe care and treatment.

The issues were:

• There was not a robust system in place to ensure that the agreement by the clinical governance lead for Patient Group Directions had been recorded to allow nurses to administer medicines in line with legislation.

• Staff who provided chaperone support when clinical staff were not available had not had appropriate training and checks to evidence that background security had been undertaken were not in place.

• There were gaps in the information retained in the practice to show that appropriate checks were carried out on locum GPs employed at the practice.

A copy of the report detailing our findings can be found at www.cqc.org.uk.

We carried out this announced focused inspection at Stockwood Medical Centre on 28 November 2016 to follow up the requirement notice which was issued on 16 December 2015 and to assess if the practice had implemented the changes needed to ensure patients who used the service were safe.

Our key findings across all the areas we inspected during this inspection were as follows:

• We saw evidence the provider had ensured there were safe systems in place for Patient Group Directions. These were adopted by the practice to allow nurses to administer medicines in line with legislation and had been signed by the clinical governance lead for the nursing staff.

• We saw evidence the provider had ensured that an appropriate system was in place for locum personnel employed to carry on the regulated activities. The practice held the required specified information in respect of persons employed by the practice as listed in Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• We saw evidence that the policy and procedure for providing chaperones had been reviewed and updated. We found staff carrying out the role were suitably trained and appropriate employment checks had been carried out.

Following this inspection the practice was rated overall as good across all domains.

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 Stockwood Medical Centre on 16 December 2015. Overall the practice is rated as good. The area of safety is an area that requires improvement.

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.

• Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was above local and national averages.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.

• 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.

• 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 new protocols for prescription security were maintained.

• The provider must ensure that appropriate training and checks are in place for staff who provided chaperone support when clinical staff were not available.

• The provider must ensure there is a robust system in place to ensure that the agreement by the clinical governance lead for Patient Group Directions have been recorded to allow nurses to administer medicines in line with legislation.

The areas where the provider should make improvement are:

• The provider should risk assess the flooring around the examination couch in the consulting room used for delivering an invasive gynaecological procedure.
• The risks of providing invasive gynecological procedures in a consulting room without an assistant to provide emergency support should be risk assessed and acted upon.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spent the day at the surgery looking at records and speaking with people. We spoke with 13 patients, eight staff, the practice manager and three GP’s.

We spoke with patients who were visiting the surgery. Patients told us they were happy with the service they received. Patient comments included; “I think the staff are marvellous”, “I always find the reception staff polite and helpful”, “I only have to ring the nurse and dressings would be provided”, “I feel safe in the nurse’s hands”.

The provider had systems in place for monitoring the quality of the service provision. There was an established system for regularly obtaining opinions from patients about the standards of the services they received. A patient told us how they asked for an additional question to be added to the recent patient survey. They told us this was actioned and we viewed this in the patient survey questionnaire. This meant that patients were involved in service improvements and their comments were valued.