This practice is rated as Good overall.
(Previous inspection 7 September 2017 Requires Improvement)
The key questions are rated as:
Are services safe? – Requires improvement
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 with dementia) - Good
We undertook a comprehensive inspection of Beech Tree Medical Practice on 7 September 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The practice was rated as requires improvement overall. They were rated as inadequate for providing safe services and required improvement in providing effective and well led services. The practice was required to produce an action plan to detail how they would meet the legal requirements in relation to the breaches in regulations that we identified in the September inspection. The full comprehensive report on the 7 September 2017 inspection can be found by selecting the ‘all reports’ link for Beech Tree Medical Practice on our website at .
We carried out a further announced comprehensive inspection on 10 May 2018 to check that the provider now complied with legal requirements. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
At this inspection we found:
- The practice had a number of 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. However, we noted that whilst there was a system for checking medicines, one medicine was out of date as the staff member had not been able to locate an expiry date. We also noted that four of the new patient group directions had not been signed by all relevant staff or the authorising person.
- The practice had introduced a more effective system for recording significant events and ensured that the lessons learned from these were shared throughout the practice.
- A series of audits had been carried out to review performance.
- 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 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 focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients.
The areas where the provider should make improvements are:
- Conduct staff training in recognising and responding to acutely unwell or deteriorating patients who may have sepsis.
- Carry out a formal fire evacuation procedure.
- Ensure results of patients who self-test for anticoagulant therapy are recorded in their records and that equipment being used by patients to monitor their blood coagulation is calibrated.
- Document in the records of those children who have not attended hospital appointments and what action was taken.
- Keep policies under review with appropriate timescales.
- Continue to identify patients and develop the register of carers to provide appropriate support.
- Explore with the CCG the formal arrangements for electrical testing of computer and IT equipment.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice