- GP practice
Trent View Medical Practice
All Inspections
22 May 2023 and 25 May 2023
During an inspection looking at part of the service
We carried out an announced focused inspection at Trent View Medical Practice on 22 and 25 May 2023. Overall, the practice is rated as requires improvement.
Safe - requires improvement.
Effective - requires improvement.
Caring - not inspected, rating of good carried forward from previous inspection.
Responsive – good.
Well-led –requires improvement.
Following our previous inspection on 25 and 31 August 2022 the practice was rated requires improvement overall and for providing effective and well led services but inadequate for providing safe services and good for caring and responsive services.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Trent View Medical Practice on our website at www.cqc.org.uk
Why we carried out this inspection.
We carried out this inspection to follow up breaches of regulation from a previous inspection.
How we carried out the inspection.
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A short site visit.
Our findings
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We found that:
The provider had made improvements to keep people safe from harm in the following areas:
- Recruitment processes.
- Standards of cleanliness and hygiene.
- Management of health and safety.
- Management of information to deliver safe care and treatment.
- Medicines management and systems in the dispensaries.
- Systems to learn and make improvements when things went wrong.
However, the provider had not always provided care in a way that kept patients safe and protected them from avoidable harm because:
- Systems practices and processes to keep people safe and safeguarded from abuse were not adequately monitored.
- Systems to monitor patients prescribed high risk medicines were not always effectively implemented.
- Safety alerts were not always acted upon.
The provider had made improvements to provide effective care in the following areas:
- Management of pathology results and documents received from secondary care.
- Access to nurse appointments.
- Staff training.
However, patients had not always received effective care and treatment that met their needs because:
- Patients with long term conditions had not always received effective care and treatment that met their needs.
- Staff training and competency had not been effectively monitored.
The provider had continued to take action to try to improve access by restructuring the service and provide new telephony equipment. Patients could mostly access care and treatment in a timely way.
Whilst the provider had made significant improvements in many areas the way the practice was led and managed did not always promote the delivery of safe, effective, high-quality, person-centred care.
We found breaches of regulations. The provider must:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The provider should:
- Take action to improve the uptake of cervical screening by patients to achieve the 80% target.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Health Care
25 and 31August 2022
During a routine inspection
We carried out an announced comprehensive inspection at Trent View Medical Practice on 25 and 31 August 2022. Overall, the practice is rated as requires improvement.
Safe - inadequate
Effective - requires improvement
Caring – good
Responsive - good
Well-led – requires improvement
Why we carried out this inspection
We carried out this inspection in line with our inspection priorities and because this is a new provider.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- Site visits to the main site and the two branch sites.
Our findings
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We found that:
- Whilst the provider had completed a risk profile and had been working to address the areas identified for improvement prior to the inspection, we found the practice did not always provide care in a way that kept patients safe and protected them from avoidable harm. Systems to manage pathology results and incoming clinical letters had not been effectively managed. Systems to manage fire safety, medicines and infection prevention and control were not effectively and consistently implemented and monitored. Recording and learning from incidents was not effective. Since the inspection, the provider has provided evidence to show they have implemented changes to address these areas.
- Patients had not always received effective care and treatment that met their needs.
- Staff had not had effective induction and training and completion of training and staff competency was not effectively monitored.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- Patients could mostly access care and treatment in a timely way. The provider had taken action to try to improve access by restructuring the service.
- The way the practice was led and managed did not promote the delivery of high-quality, person-centred care. The provider had identified areas for improvement prior to the inspection and had been working to improve. We found additional areas of risk during the inspection and the provider was proactive in addressing these areas immediately following the inspection.
We found two breaches of regulations. The provider must:
Ensure care and treatment is provided in a safe way to patients.
Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.
The provider should:
- Provide signed contracts for staff and obtain complete employment history for all staff.
- Take action not to overload plug sockets.
- Take action to improve the Keadby dispensary to provide enough room for storage and dispensing.
- Take action to improve availability of nurse appointments and for cervical screening and improve the uptake of cervical screening by patients to achieve the 80% target.
- Take action to improve the telephone access at Crowle surgery.
- Take action to improve the detail in records of medicines reviews.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services