Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Foreland Medical Centre on 8 October 2015. The practice was rated requires improvement in Safe, however the overall rating for the practice was good as these were the ratings for the effective, caring, responsive and well-led domains. The full comprehensive report on the October 2015 inspection can be found by selecting the ‘all reports’ link for The Foreland Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 20 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in October 2015. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

• The practice had some systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• The practice should ensure they have processes in place to demonstrate that all clinicians were aware of the latest clinical guidance.

• Continue to implement processes to improve the uptake rates for the children’s vaccinations.
• Implement a system to ensure staff had read, understood and complied with the policies and procedures.

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 The Foreland Medical Centre on 8 October 2015. Overall the practice is rated as Good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Our key findings were as follows:

• Staff were clear about reporting incidents, near misses and concerns and there was evidence of communication of lessons learned with staff.
• The practice worked in collaboration with other health and social care professionals to support patients’ needs and provided a multidisciplinary approach to their care and treatment.
• The practice promoted good health and prevention and provided patients with suitable advice and guidance.
• The practice had several ways of identifying patients who needed additional support, and was pro-active in offering this.
• The practice provided a caring service. Patients indicated that staff were caring and treated them with dignity and respect. Patients were involved in decisions about their care.
• The practice provided appropriate support for end of life care and patients and their carers received good emotional support.
• The practice learned from patient experiences, concerns and complaints to improve the quality of care.
• The practice had a clear, patient-centred vision and staff were clear about the vision and their responsibilities in relation to this.
• There was an open culture and staff felt supported in their roles.

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

Importantly, the provider must:

• Ensure care and treatment is provided in a safe way for patients through the proper and safe management of medicines, in particular in relation to the security of prescriptions.

In addition the provider should:

• Ensure a record is kept of the regular fire drills carried out;
• Install an emergency pull cord in the disabled toilet;
• Ensure that all clinical staff are able to access recall alerts on the practice’s computer system for patients on high risk medicines to provide more demonstrable oversight of these patients;
• Ensure the recent DBS checks for the nurse and healthcare assistant carried out in previous employment are updated by the practice’s own DBS checks;
• Ensure discussion of informed consent for medical procedures is recorded in the patient’s notes in all cases;
• Arrange further development of practice policies to tailor them specifically to the practice and remove references to organisations no longer in existence;
• Consider making a written record of GP partner meetings to document action agreed to drive improvement, and enable follow up and review of progress to be tracked at subsequent meetings

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice