Christchurch Medical Practice

Letter from the Chief Inspector of General Practice

We carried out a desktop review of the Orchard Surgery on 16 September 2016. This review was performed to check on the progress of actions taken following an inspection we made in May 2016. Following that inspection the provider sent us an action plan which detailed the steps they would take to meet their breach of regulation. During our latest desktop review on 16 September 2016 we found the provider had made the necessary improvements.

This report covers our findings in relation to the requirements and should be read in conjunction with the report published in August 2016. This can be done by selecting the 'all reports' link for the Orchard Surgery on our website at www.cqc.org.uk

Our key findings at this inspection were as follows:

The practice had improved the governance systems ensuring that mandatory training was managed effectively so that patient safety was promoted and any risks that could affect the quality of care were reduced. This included the introduction of:

• A system to monitor training, which provided managers with an overview of all staff training at the practice.

• The inclusion of training needs and gaps as a standing item for discussion at GP partnership meetings.

• Oversight of fire safety training and drills was carried out by a named person and monitored at GP partnership meetings.

• Chaperone training was provided in July 2016 for all staff undertaking this role.

• Mental Capacity Act 2005 training was provided for 10 staff in July 2016.

• A fire drill took place across Christchurch Medical Centre in September 2016.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Orchard Surgery located at Christchurch Medical Centre on 17 and 18 May 2016. Overall the practice is rated as good.

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. This was beginning to influence the development of a common approach across all three practices based at Christchurch Medical Centre.
• Risks to patients were assessed and well managed. The practice provided leadership and managed a team, which proactively managed vulnerable patients and those at risk of unplanned hospital admission.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• Governance systems in regard of patient safety were not effective in picking up gaps in training for staff in regard to the role and responsibilities of a chaperone, the Mental Capacity Act 2005 or fire safety.

We saw two areas of outstanding practice:

• Orchard Surgery provided leadership for the Action Management Before Emergency Risk team (AMBER), providing proactive support to vulnerable patients to avoid unplanned hospital admissions where ever possible. Data across all three practices demonstrated that patients were successfully cared for in the community limiting the number of unplanned hospital admissions for them.

• GPs held lead roles with the Dorset Clinical Commissioning Group for prescribing and safeguarding. Through this engagement with local GP practices, the GPs promoted better patient experience and joined up working. A safeguarding template for both adults and children had been created, by a GP from the practice, with hyperlinks to current guidelines and had been rolled out to other practices in the area.

The areas where the provider must make improvement are:

• Ensure that mandatory training is managed effectively so that patient safety is promoted andany risks that could affect the quality of care are reduced. These must include effective monitoring of fire safety training and drills, Mental Capacity Act 2005 training for all staff, and chaperone training for those staff undertaking this role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice