Archived: Garston Family Health Centre

This practice is rated as Good overall.

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

We carried out an announced comprehensive inspection at Garston Family Practice on 6 June 2018 as part of our inspection programme

At this inspection we found:

• The practice was one of a group of six practices that had recently been taken over in April 2017 by a new provider. There had been initial challenges for the provider in ensuring that each practice had sufficient staff and effective teams in place. The provider had focused on staff training and well – being to empower staff; and improving mechanisms for patient engagement to drive patient centred care.
• Systems and processes were still in the process of being developed and improved across all of the practices. Incidents and complaints were monitored centrally by the provider. When incidents did happen, the practice learned from them and improved their processes. However, we found that policies and the degree of provider oversight needed to be expanded to improve the safety mechanisms already in place; and improve clinical support to ensure all clinicians are supported to keep up to date with best practice guidance and legislation.
• We identified some gaps in monitoring systems for: when essential health and safety and fire safety checks of the premises were due; checking that clinicians used appropriately calibrated equipment; prescribing safety; and checking the ongoing immunisation status of staff.
• The practice had access to a defibrillator in the building. However, the practice did not have a sharing agreement and did not have records that showed the equipment was being maintained and serviced.
• Systems and processes for safeguarding required improvement.
• Staff understood the requirements of the duty of candour.
• The practice routinely monitored its performance against contractual requirements however there was very little evidence of clinical audit for quality assurance.
• Staff felt well supported by management and worked well together as a team. They received appropriate training for their role and had opportunities for career development. There was some evidence of performance management of GPs at this practice but overall the provider needed a more robust system of consultation, referral and prescribing audits.
• Patient feedback and complaints, we reviewed indicated that generally staff treated patients with compassion, kindness, dignity and respect. However, there were some concerns raised with regards to some GP’s attitude. The practice was aware of this and had taken steps to remedy this.
• The practice used locum GPs and routine appointments before 9.30am and after 5pm were not always available. Some patient feedback we reviewed also commented on long waiting times for appointments.

The areas where the provider must make improvements are:

• Ensure patients are protected from abuse and improper treatment.
• Ensure patients receive safe care and treatment

The areas where the provider should make improvements are:

• Monitor the ongoing immunisation status for all staff.
• Have a written agreement for the sharing of the use of the defibrillator in the building.
• Introduce a schedule of clinical audits and expand prescribing, consultation and referral audits.
• Increase the availability of GP appointments especially for the working population.
• Review and expand the policies and the degree of provider oversight to improve the safety mechanisms already in place; and improve clinical support to ensure all clinicians are supported to keep up to date with best practice guidance and legislation.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice