Newbold Verdon Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newbold Verdon Medical Practice 1 November 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.
• Risks to patients were assessed and well managed.
• 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. The doors were not automatic a bell was available so that reception staff could assist patients.
• 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.
• Two of the GPs in the practice had morphine in their bag that they took on home visits. Guidance states that if this is kept it should be in a lockable bag, box or case. One of the GP’s bags was not able to be locked.
• Fridge temperatures in the dispensary at Newbold Verdon were not recorded daily and on the days that they were recorded as been out of range no action had been taken and staff we spoke with were unaware of what action to take.
• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active
• A programme of continuous clinical and internal audit was not used to monitor quality and to make improvements. However the practice had already identified that this was an area that needed improvement before our inspection.
• Meetings with other health care professionals when care plans were routinely reviewed and updated for patients with complex needs were not regular.
• Staff in the dispensary at Newbold Verdon were not aware of the process to follow when fridge temperatures were out of the required range. This was rectified the day of the inspection with a flow chart secured to the fridge.
• The practice were not at the time of the inspection holding safeguarding meetings with relevant staff to ensure that any patients were discussed and monitored with other agencies. The practice had highlighted this prior to the inspection and had arranged their first meeting to be held 9 November 2016.

We saw one area of outstanding practice:

• The practice identified patients that were at risk of loneliness such as those older patients that were widowed or those that lived alone. These patients were invited to coffee and cake mornings held at the practice. The practice also ran trips annually in conjunction with the PPG. Trips included shopping trips and more recently a trip to Arbetorum. We saw thank you cards from patients that had attended and photographs of events on the noticeboard in the waiting area. These events were funded by the PPG through fundraising raffles at both sites. The practice invited approximately 35 patients to the PPG day trips and 15-20 patients to the tea and cake afternoons due to space.The practice tried to ensure patients who had not yet attended were invited to each new event organised.

The areas where the provider must make improvement are:

• Ensure that morphine (if kept by GP’s for home visits) is stored suitably in line with national guidance.

The areas where the provider should make improvement are:

• Continue to monitor and review cold chain process to unsure staff are taking appropriate actions.
• Continue process for multi-disciplinary and safeguarding meetings to ensure patients are reviewed and monitored regularly.

• Review clinical audit programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice