This practice is rated as Good overall. (Previous inspection August 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced inspection at Greengate Medical Centre on 13 March 2018 as part of our inspection programme.
At this inspection we found:
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There was an effective system in place to deal with safeguarding and staff demonstrated that they understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.
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Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
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There were processes for handling repeat prescriptions which included the review of high risk medicines.
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We found that the system to maintain the cold chain was not operating effectively as refrigerators used to store vaccines did not have a secondary thermometer in place and there had been issues with temperature recording. The refrigerators had not been serviced annually. The practice took action on the day of inspection to rectify this.
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We found that the storage of equipment and medicines would benefit from being rationalised to avoid a delay in accessing medicines or equipment required in an emergency.
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Not all recruitment information was available in staff files and therefore there was no assurance that all necessary employment checks had taken place, particularly in respect of locum GPs. The practice told us following the inspection that this was being addressed.
- Staff told us they had been trained to provide them with the skills and knowledge to deliver effective care and treatment. However, there were some gaps in training and the practice had an action plan in place to address this. Staff had received appraisals in the last 12 months.
- Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
- Information about services and how to complain was available, although this had to be requested from a receptionist. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients commented that they were pleased with the care they received and were able to get appointments when they needed them.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a leadership structure whereby staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
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Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
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The practice had a range of practice specific policies but we found some examples where the practice had not acted in accordance with their own policies.
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Not all systems and processes within the practice were operated effectively. Governance arrangements were in place but some areas identified during our inspection indicated a lack of oversight.
The areas where the provider must make improvement are:
Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. More detail can be found in the requirement notice section at the end of this report.
The areas where the provider should make improvements are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice