Park View Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park View Medical Practice on 3 February 2016. The overall rating for the practice was ‘requires improvement’. The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for Park View Medical Practice on our website at www.cqc.org.uk.

At our previous inspection in February 2016 we rated the practice as ‘requires improvement’ for each of the key questions we inspect against. The practice was therefore rated as ‘requires improvement’ overall. We issued five requirement notices to the provider relating to; clinical effectiveness, medicines prescribing, emergency medicines, the management of complaints, staffing levels and for a lack of effective systems being in place for assessing and monitoring the quality of the service and governing the practice.

This inspection visit was carried out on 25 April 2017 to check that the provider had met their plan to meet the legal requirements.

The findings of this inspection were that whilst the provider had taken some action to meet the requirement notices these were not always sufficient to make a significant improvement and as a result the practice continues to be rated as requires improvement.

Our key findings were as follows:

• Improvements had been made to the way significant events were managed and a periodic review of events was now in place. However, we saw a number of examples where the provider had failed to recognise an event as a significant event and therefore they had not taken action to investigate the matter or to put systems in place to prevent a reoccurrence.

• Improvements had been made to how complaints were managed. However, there was room for continued improvement as we saw that not all complaints had been fully explored and some issues should have been recognised as a significant event and managed as such.

• The provider had taken action to make improvements to the range and storage of emergency medicines. However, not all emergency medicines could be readily located by staff. Not all staff had been provided with up to date training in basic life support.

• The GPs were able to demonstrate how they used best practice guidance in the care and treatment provided to patients.

• The practice used performance indicators to measure their performance. Data showed that the practice achieved results comparable to other practices locally and nationally for outcomes for patients.

• The provider had carried out a review of staffing and had increased clinical staffing.

• There were gaps in staff training as not all staff had undergone training or updated their training in key topics such as safeguarding, basic life support and infection control.

• The majority of patients we spoke with said they were treated with care and concern and involved in decisions about their care and treatment. However, a number of patients were not complimentary about some of their experiences during consultation with GPs.

• National patient survey results showed that the practice received lower than local and national average scores for patient experience of the care and treatment provided.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• Infection control practices were in place and there were regular checks on the environment and on equipment used.

• The practice provided a range of enhanced services to meet the needs of the local population.

• Clinical meetings had been introduced since our last inspection visit. However, arrangements for clinical governance required further improvement.

• Patient records were not maintained securely in line with data protection legislation.

Areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

• Review significant events reporting to be clear about what constitutes a significant event and to ensure events are being captured and acted upon. To include clearly recording the investigations behind significant events.

• Improve the arrangements for the monitoring of patients on high risk medicines and for patients who require an annual review of their medicines.

• Review the arrangements for storing emergency medicines and for training staff in dealing with medical emergencies.

• Ensure the arrangements for protecting information are in line with data protection legislation.

• Ensure all staff are provided with up to date training to support them in their roles and responsibilities.

Areas where the provider should make improvements:

• Review staffing levels to ensure there are sufficient numbers of staff to support the running of the service.

• Use the electronic patient records system more effectively to provide information on the needs of the patient population.

• Improve the system for managing patient safety alerts to demonstrate the actions taken in response.

• Improve the standard of administrative/practice process record keeping to ensure appropriately detailed records are maintained.

• Increase the number of identified carers to ensure these patients are provided with information about the support available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice