7 June 2018
During a routine inspection
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 West Speke Health Centre on 7 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.
- Systems and processes for safeguarding required improvement.
- The practice did not have a defibrillator to treat medical emergencies for cardiac arrest. We were assured after the inspection that this would be purchased.
- 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.
- Some patient feedback we reviewed 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.
- Introduce a schedule of clinical audits and expand prescribing, consultation and referral audits.
- 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 FRCGP
Chief Inspector of General Practice