Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of The Groves Medical Centre on 12 May 2015. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breaches of regulation 12(1)(a)(d)(e) Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this desk-based focussed inspection on 14 June 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and where further improvements have been made since the comprehensive inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Groves Medical Centre on our website at www.cqc.org.uk.

The practice was previously rated as Good overall following the comprehensive inspection, however the practice was rated as Requires improvement for people whose circumstances make them vulnerable. Specifically, following this focussed inspection we now found the practice to be good for providing safe services.

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

• Risks to patients were assessed and well-managed, specifically those related to health and safety, equipment checks and responding to emergencies.
• Systems were in place to ensure that safety alerts and significant events were actioned appropriately.

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 Groves Medical Centre on12 May 2015.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was rated as requires improvement for providing safe services. It was rated as requires improvement for providing services to the population group for People whose circumstances may make them Vulnerable, and rated as good for the remaining five population groups we report on: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); and People experiencing poor mental health (including dementia).

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.
• Risks to patients were assessed, however not all risk assessments were recorded.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• There was a good skill mix amongst doctors and nursing staff with a number of clinicians having specialised areas of expertise.
• Patients said they were treated with compassion, dignity and respect by the doctors, and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice could evidence positive outcomes for patients as a result of audits they had completed.
• The practice achieved 895 points out of a total of 900 for the year 2013/14 (four percentage points above CCG Average and six above England Average).
• Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for bookable appointments.
• The practice held regular clinical and non-clinical meetings and minutes were recorded.
• The practice had sought feedback from staff and patients, and had acted upon that feedback.
• The practice had achieved above the CCG and national average for childhood immunisations.
• The practice fell below the CCG and national average for the number of patients who were satisfied with the appointment system and the ease of getting though on the phone.
• Not all staff were aware where emergency equipment was located, and some equipment was out of date.
• The practice fell below the CCG and national average for flu vaccinations for patients over 65 years and for those under 65 years in the defined influenza clinical risk groups.
• A review of patient records indicated there was room for further development of care plans.
• There were no clear lines of delegation to ensure key tasks were performed when principal staff were absent.

We saw one area of outstanding practice:

• The practice offered work placements to students from the local Council apprenticeship scheme. These apprentices are enabled to gain a range of skills and training. If they showed an aptitude for the work, where possible they would be offered a permanent position with the opportunity for further training and development. Current and former apprentices who were now permanent employees spoke highly of the opportunities provided by the GP practice.

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

Importantly the provider must:

• Ensure all equipment is within its use by date.
• Ensure all staff know where to find the emergency medicines and nebulisers.
• Ensure health and safety risk assessments are documented.

In addition the provider should:

• Ensure all clinical staff receive clinical alerts and minutes of clinical meetings.
• Record the action taken as a result of learning from significant events.
• Introduce a process for checking that equipment in GP bags is correctly maintained and all doctors are aware of and follow the practice policy regarding medicines in those bags.
• Record minutes of the practice governance meetings.
• Ensure the complaints leaflet is on display in the reception area.
• Ensure certificates relating to staff training are available.
• Carry out annual basic life support training.
• Ensure there are clear lines of delegation to provide a continuity of service when staff are absent.
• Ensure appropriate care plans are in place where there is an identified need for them.
• Ensure that patients with a learning disability receive an annual review.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice