Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 13 April 2016. A breach of regulation 17 (2)(a)(e) Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was found, as the practice had not completed any full-cycle audits. After the comprehensive inspection, the practice submitted evidence to show that they were now meeting the requirements of regulation 17.

During the initial inspection we also found areas where the practice should make improvements. We found that they had processes in place to monitor that all permanent staff were up to date with professional registrations and essential training, but this did not include long term locum staff; the practice responded promptly to all complaints, but did not include information about advocacy organisations or the Health Service Ombudsman in their responses; the practice had identified 28 patients who were carers, which represented less than 1% of their practice list; the practice had completed an infection control audit, but had not produced an action plan to address areas identified for improvement.

We undertook this desk-based focussed inspection on 19 December 2016 to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Thameside Medical Practice on our website at www.cqc.org.uk.

Overall the practice was rated as Good following the comprehensive inspection, however they were rated as requiring improvement for effective services. Following the desk-based review we found that the practice is now rated as good for providing effective services.

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

• The provider had completed two full cycle audits, which demonstrated improvements in the care provided to patients.

• The practice had processes in place to monitor that all staff, including locum staff, were up to date with training and professional registrations.
• The practice ensured that their responses to patient complaints included contact details for the NHS complaints advocacy organisation and for the Health Service Ombudsman.
• The practice had identified seven further carers, bringing the total number of carers to 35; whilst this was an improvement, the proportion of carers identified was still less than 1% of the total patient list.
• The practice had undertaken and recent infection control audit and had addressed the areas identified for improvement.

The areas where the practice should make improvement are:

• They should continue to identify patients with caring responsibilities.

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 of Thameside Medical Practice on 13 April 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.
• Overall, risks to patients were assessed and well managed, with the exception of the arrangements for responding to medical emergencies and the monitoring of the safe storage of vaccines.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. The practice had processes in place to ensure that staff were up to date with training and professional registrations; however, this did not include their regular locum GP.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand; however, the patient information that we saw did not direct people to contact the Health Service Ombudsman if they were unhappy with the handling of their complaint. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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 improvements are as follows:

• Put processes in place to improve quality, including carrying-out completed audit cycles.

The areas where the provider should make improvements are as follows. They should:

• Ensure processes are in place to monitor that locum staff are up to date with training and professional registrations.
• Review responses to complaints to include all the required information.
• Ensure that they are identifying carers so they can be signposted to appropriate support.
• Ensure that an action plan is in place to address issues identified by the infection control audit.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice