Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Eastwick Park Medical Practice on 10 September 2015. Overall the practice is rated as requires improvement.
Specifically, we found the practice to require improvement for providing safe, effective, and well led services. It also required improvement for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). It was good for providing caring and responsive services.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
- Risks to staff, patients and visitors were not always formally assessed and monitored. The practice did not have a supply of oxygen and had not assessed the risks associated with their management of medical emergencies. The practice had not assessed the risks of potential exposure to Legionella bacteria.
- The practice had not ensured the safe and secure storage and distribution of prescription pads.
- Staff had not always received training appropriate to their roles and further training needs had not always been identified and planned.
- Staff had not received regular appraisal of their performance.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance.
- The practice worked closely with other organisations and with local community services in planning how care was provided to ensure that they met people’s needs.
- There were systems in place for completing clinical audit cycles and we saw that audits were driving improvement in performance to improve patient outcomes.
- 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.
- Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for non-urgent appointments. There were no extended hours appointments available to patients.
- The practice had a number of policies and procedures to govern activity. The practice held regular governance meetings and issues were discussed but not always clearly recorded.
- The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
The areas where the provider must make improvements are:
- Ensure staff undertake training to meet their needs, including training in the safeguarding of children and vulnerable adults, the Mental Capacity Act 2005, information governance, fire safety, health and safety and infection control.
- Ensure all staff receive regular supervision and appraisal.
- Ensure criminal records checks via the Disclosure and Barring Service are undertaken for all staff who are assessed as requiring a check, such as staff who act as chaperones.
- Ensure there are formal arrangements in place for assessing and monitoring risks to staff, patients and visitors, including the management of medical emergencies and the risk of exposure to legionella bacteria.
- Ensure the security and tracking of blank prescription pads at all times.
- Ensure that records are maintained and circulated which accurately reflect the management of services provided, including records of clinical meetings, training activities, reviews of infection control audits and learning from safety incidents.
In addition the provider should:
- Improve signage to ensure patients are made aware of the chaperone service available.
- Improve access to extended hours appointments for patients.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice