Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection in January 2016 rated the service as Good overall).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people living with dementia) - Good

We carried out an announced comprehensive inspection at Wombwell Medical Centre on 11 December 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider continues to meet the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had clear 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 had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
• 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.
• Clinical audits demonstrated quality improvement.
• There was evidence of appraisals and personal development plans for all staff.
• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.
• 79 out of 83 patient Care Quality Commission comment cards we received were positive about the service experienced. This is in line with the results of the NHS Friends and Family Test and other feedback received by the practice.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff worked together and with other health and social care professionals to deliver effective care and treatment.
• The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw two areas of outstanding practice:

• The practice organised a ‘tea party’ in collaboration with Barnsley Independent Alzheimer’s and Dementia Support, South Yorkshire Dementia Alliance, and South Yorkshire Housing Dementia support for all patients and carers. This event covered fire safety and all patients were offered a home visit for assessments and improvements. All families and carers were supported to complete a Herbert protocol for all patients. (The Herbert Protocol is a national scheme being introduced by the Met in partnership with other agencies which encourages carers to compile useful information which could be used in the event of a vulnerable person going missing.)
• The practice had developed a protocol to ensure secondary care and community services were informed of patient deaths. This was to prevent further mail for the patient being sent out.

The areas where the provider should make improvements are:

• The provider should review the processes to ensure the competencies of the advanced nurse practitioners clinical decision making skills and non-medical prescribing.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a follow up inspection on 10 November 2015 at Wombwell Medical Centre Practice as a result of the practice currently being in special measures due to non-compliance with the Health & Social Care Act 2008 (Regulated Activities) Regulation 2010 and the Regulations 2014 following our previous inspection in December 2014.

During this inspection in November 2015, we found the practice had made significant improvements since our last inspection in December 2014 and that they were meeting all of the three requirement notices and three warning notices which had previously been issued. The ratings for the practice have been updated to reflect our findings. The practice is rated as good for providing caring, safe, responsive, effective and well led care.

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.

• 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 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.

I confirm that this practice has improved sufficiently to be rated ‘Good’ overall. The practice will be removed from special measures.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection in January 2016 rated the service as Good overall).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people living with dementia) - Good

We carried out an announced comprehensive inspection at Wombwell Medical Centre on 11 December 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider continues to meet the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had clear 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 had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
• 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.
• Clinical audits demonstrated quality improvement.
• There was evidence of appraisals and personal development plans for all staff.
• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.
• 79 out of 83 patient Care Quality Commission comment cards we received were positive about the service experienced. This is in line with the results of the NHS Friends and Family Test and other feedback received by the practice.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff worked together and with other health and social care professionals to deliver effective care and treatment.
• The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw two areas of outstanding practice:

• The practice organised a ‘tea party’ in collaboration with Barnsley Independent Alzheimer’s and Dementia Support, South Yorkshire Dementia Alliance, and South Yorkshire Housing Dementia support for all patients and carers. This event covered fire safety and all patients were offered a home visit for assessments and improvements. All families and carers were supported to complete a Herbert protocol for all patients. (The Herbert Protocol is a national scheme being introduced by the Met in partnership with other agencies which encourages carers to compile useful information which could be used in the event of a vulnerable person going missing.)
• The practice had developed a protocol to ensure secondary care and community services were informed of patient deaths. This was to prevent further mail for the patient being sent out.

The areas where the provider should make improvements are:

• The provider should review the processes to ensure the competencies of the advanced nurse practitioners clinical decision making skills and non-medical prescribing.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We last inspected Wombwell Medical Centre on the 3rd December 2013 and made a compliance action because we found the provider had failed to assess and monitor the quality of the service.

During our inspection on the 31st July 2014 the provider was able to provide us with evidence which demonstrated they had made all the necessary improvements to assess and monitor the quality of the service, which included gathering feedback from patients.

During our inspection we spoke with eight people using the service and various members of staff including the practice manager, the GPs, the nursing staff, reception and administrative staff.

People that we spoke with were positive about the practice and the staff. Some comments included “They are lovely, happy to listen and don’t rush you along” and “They make me feel like family.”

All the people spoken with told us that they felt comfortable whilst being examined by the clinical staff and did not have any concerns.

We saw that the practice was well organised and clean and tidy. Some comments included "It’s always clean here, no complaints" and "The staff keep it nice."

All the staff spoken with told us that they enjoyed working at the practice and that they could ask for support when they needed to. We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We found that the provider did not had an effective system to regularly assess and monitor the quality of service that people receive.