Archived: Shinfield Health Centre Also known as South Reading and Shinfield Group Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shinfield Health Centre on 11 January 2017. Overall the practice is rated as requires improvement. Specifically the practice is rated good for the provision of effective services and requires improvement for the provision of safe, caring, responsive and well-led services.

Our key findings across all the areas we inspected were as follows:

• The practice was managed by partners of another practice nearby. Data and feedback from patients was combined across both practice locations. Patients registered at the practice could also be seen at the nearby practice if this was more convenient for them.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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. However, at the time of inspection the lead for infection control had not received training relevant to this responsibility. The practice has since inspection made relevant training available.
• Most patients said they were treated with compassion, dignity and respect. However, feedback relating to involvement in their care and decisions about their treatment was below average.
• Patients said they could obtain urgent appointments on the same day and received continuity of care. The practice had reviewed appointment systems and was introducing a revised more flexible appointment system within two weeks of this inspection.
• 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. However, the response to patient feedback was inconsistent.
• Most risks to patients were assessed and well managed. However, some aspects of the legislation regarding control of substances hazardous to health (COSHH) were not being met. The practice has, since inspection, dealt with these matters. Some recruitment checks had not been recorded.
• Information about services and how to complain was limited in availability. The system for ensuring improvements were made to the quality of care as a result of complaints and concerns was managed inconsistently. Communication of learning from complaints was not always effective.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Monitoring arrangements for the administration of medicines had not identified that the appropriate legal requirements were not being followed when the health care assistant administered vaccinations.
• Health checks were offered to a wide range of patients with long term conditions but arrangements to deliver annual health checks for patients diagnosed with a learning disability were not in place.
• Information leaflets were available but these were not held in languages other than English. A significant number of patients were registered from Southern Asia whose first language was not English.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all necessary employment checks for all staff.

• Ensure arrangements to identify, assess and manage risk are operated consistently. For example in complying with COSHH regulations and making relevant training in control of infection available.

• Ensuring the views of patients expressed in the national patient satisfaction survey are considered when delivering care and treatment. Also ensure that when changes in service delivery are made, in response to feedback, they are monitored and evaluated.

• Ensure medicines are administered in accordance with national guidance and legislation at all times.

• Ensure learning from complaints is communicated consistently.

In addition the provider should:

• Ensure arrangements are in place for patients diagnosed with a learning disability to receive an annual health check and encourage patients to take part in the national breast and bowel cancer screening programmes.

• Provide practice information in appropriate languages and formats.
• Ensure updates in practice policies and protocols are shared with staff in a timely manner.

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Professor Steve Field

CBE FRCP FFPH FRCGPChief Inspector of General Practice