We previously carried out an announced comprehensive inspection at The Swan Medical Centre on 14 November 2016. The overall rating for the practice was good, with good ratings in safe, effective, caring and well-led services and requires improvement rating in responsive services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for The Swan Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 February 2018 to confirm that the practice had carried out improvements in relation to the areas of improvements we identified in our previous inspection on 14 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice had made significant improvements to ensure all staff were kept informed of significant events and any related learning.
• The practice had implemented an audit process for its stock of vaccines. Vaccine stock was stored and managed appropriately.
• Patient feedback remained mixed regarding telephone access. However, the practice had made significant improvements to its process of monitoring the effectiveness of actions taken regarding telephone access.

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

The provider should:

• Continue to explore options to improve telephone access further and continue to monitor the effectiveness of actions taken regarding patient telephone access.
• Consider monitoring trends in incidents and complaints to further identify areas of improvement or areas where they are doing well.

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 Swan Medical Centre on 14 November 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 been trained to provide them with 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.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• Patient feedback suggested that they found it difficult to access the practice via the telephone at peak times and therefore did not find it easy to make an appointment.

• 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 should make improvement are:

• Review its processes to enable learning from significant events to be shared with all the practice team and documented.

• Implement an audit process for its stock of vaccines.

• Develop processes to monitor the effectiveness of actions taken regarding patient telephone access.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with six patients, two GPs, two nurses and three staff members during our visit. All of the patients we spoke with were generally pleased with the service they received from the practice. One patient said: “They are like a friend, family really”. All the patients we spoke with were positive about the staff at the practice. One patient said: “Staff always say hello, we have a laugh with the staff”.

Patients told us they were able to see a GP when they needed to. Patients told us they felt listened to and involved in their care. They said treatment options were discussed with them, and results of tests were fully explained. One patient told us: “They explain things and put my mind at rest, I had a scan and the GP explained it all”

We saw evidence of guidance in place to protect vulnerable adults and children.

Staff we spoke with told is they were supported to deliver care to an appropriate standard.

Patients were encouraged to share their views and highlight areas for improvement at the practice through surveys. There were systems in place for monitoring the quality of service provision.