Knowle Green Medical

Background to this inspection

Updated 21 March 2017

Knowle Green Medical is based in a large single storey purpose built health centre. The property is leased from NHS Property Services Ltd and Knowle Green Medical is not the major tenant. There are a variety of other services located in the building including two other GP practices and community services including podiatry and health visitors. The practice holds a contract to provide general medical services and at the time of our inspection there were approximately 7,500 patients on the practice list. The practice has a slightly higher than average number of patients aged 25 to 50 years, there is a slightly lower than average number of patients aged five to 20 years and 50 to 84 years old. The practice also has a higher than average number of patients with long standing health conditions. The practice is located in an area that is considered to be in the second least deprived centile nationally.

The practice has three GP partners and one salaried GP (one male, three female). They are supported by three practice nurses, a practice manager and a team of clerical and reception staff. The practice is a training practice and at the time of our inspection there was one GP registrar training with the practice. (A training practice has GP trainees who are qualified doctors completing a specialisation in general practice.)

The practice is open between 8am and 6pm Monday to Friday. Extended hours appointments are offered 6.30pm to 7pm Wednesday and Thursday evenings and Saturday morning from 8.30am to 11am . When the practice is closed between 6pm and 6.30pm there is a telephone answering service which directs calls to the duty doctor provided by the practice, between 6.30pm and 8am patients are advised to call NHS 111 where they will be given advice or directed to the most appropriate service for their medical needs.

The service is provided from the following location:

Knowle Green Medical

Staines Health Centre

Staines

Middlesex

TW18 1XD

Overall inspection

Good

Updated 21 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Knowle Green Medical on 20 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Knowle Green Medical on our website at www.cqc.org.uk.

During the inspection we found breaches of legal requirements and the provider was rated as requires improvement under the safe, effective and well led domain. Following this inspection the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

Ensuring recruitment arrangements include all necessary employment checks for all staff.
Ensuring that training appropriate to job role is completed for all staff.
Ensuring that policies and procedures are reviewed and up to date.
Ensuring the proper management of clinical waste.
Ensuring that prescription paper is stored securely.
Ensuring that comprehensive risks assessments are completed where required.
Ensuring that all staff know the locations of emergency equipment and medicines.
Ensuring that information for patients about how to complain includes signposting information should the patient not be satisfied with the practice’s response and that learning from all complaints is shared appropriately.

This inspection was an announced focused inspection carried out on 07 March 2017 to confirm that the practice had carried out their plans to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 20 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings at this inspection, 07 March 2017, were as follows:

A system to monitor training had been put in place and staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
All policies and procedures had been reviewed and were up to date.
Risks to patients were assessed and managed, including those related to recruitment checks, risk assessments, infection control, storage of clinical waste, security of prescription paper and training.
Information about services and how to complain was available and easy to understand and improvements were made to the quality of care as a result of complaints and concerns.
The locations of emergency medicines and equipment were clearly signed and all GPs and staff had been made aware of their location.

Our previous report also highlighted the following areas where the practice should improve:

Review confidentiality arrangements with other services who share communal areas.
Review exception reporting within the practice.
Develop methods to increase the uptake of cervical screening and childhood immunisations.

During our inspection 07 March 2017 we saw evidence that a confidentiality sharing agreement was in place with the other services who share communal areas, and that the uptake of childhood immunisations in two year olds and cervical screening had improved. We noted that the immunisation rates for five year olds was still below local and national averages. We also noted that although overall exception reporting was comparable to local and national averages there were some areas where exception reporting was still high.

However, the areas of practice where the provider should make improvements are.

Continue to review and improve where possible exception reporting within the practice.
Continue to develop methods to increase the uptake of childhood immunisations.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice