The Care Quality Commission
  • Doctor
  • GP practice

Archived: RK Medical Practice

Overall: Good read more about inspection ratings

Brownley Green Health Centre, 171 Brownley Road, Wythenshawe, Lancashire, M22 4GL (0161) 493 9493

Provided and run by:
RK Medical Practice

All Inspections

8 January 2018

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RK Medical Practice on 31 July 2017. The overall rating for the practice was Good, with requires improvement for the key question providing effective services. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all reports’ link for RK Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 8 January 2018 to confirm that the practice had achieved improvements to patient outcomes. This report covers our findings in relation to those additional improvements made since our last inspection.

Overall the practice is rated as Good,with the effective domain now rated Good

Our key findings were as follows:

  • The practice had sustained an improvement in clinical outcomes for patients

  • The introduction of the community practice nurse maximised the contact with patients.

  • The management of patients with long term conditions had improved with an increase in patient reviews.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

31 July 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RK Medical Practice on 20 October 2016. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for RK Medical Practice on our website at www.cqc.org.uk.

At the inspection in October 2016 we found the practice did not have comprehensive systems in relation to safety and governance, staff training and appraisals were lacking and there were shortfalls in the required recruitment procedures. Warning notices were issued, with the practice required to undertake action to meet the regulations in relation to safe care and treatment and good governance.

This most recent inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 31 July 2017. Overall the practice is now rated as Good.

Our key findings at this inspection were as follows:

  • We had previously identified a number of areas of potential risk to both patients and staff including the lack of risk assessments for fire safety, legionella and the general environment. Evidence at this inspection demonstrated that safe and comprehensive systems had been implemented to address these areas.

  • Appropriate recruitment checks were completed and staff personnel files were now in place to document these for all staff.

  • Systems to securely store and monitor the use of prescription pads had improved.

  • Systems to recognise, record, and respond to significant events had improved and these were supported by an updated incident policy. Evidence was available that demonstrated outcomes and learning from significant events and complaints were shared.

  • Governance arrangements had improved significantly and there was a clear staffing and organisational structure with identifiable roles and responsibilities.

  • Practice meetings were now scheduled weekly and these were minuted.

  • Records of staff training showed that a range of training including fire safety and safeguarding had been completed. Additional training was planned.

  • The practice had updated and reviewed policies and procedures. These were available for staff and practice meeting minutes demonstrated these were shared and discussed with the team. Staff were aware of the new policies introduced.

  • Unverified data provided by the practice indicated there had been some progress in clinical outcomes, although work needed to be continued to improve patient outcomes.

  • Instructions to enable nurses to administer medicines safely were signed and dated by GPs and the practice nurse.

  • Patient feedback was positive about the practice and about all staff and patients said they were treated with compassion and dignity.

  • A Patient Participation Group had been formed and was being supported by a GP who had retired from the practice at the time of the last inspection.

The areas where the provider should make improvement are:

  • Continue work to demonstrate quality improvements for patients outcomes

  • Review the investigated significant events within the agreed timeframes and as per policy.

  • Consider the content and style of the letters to complainants to ensure a more detailed response is recorded

  • Continue to identify and support patients who are also carers

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

20 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RK Medical Practice on 20 October 2016. Overall the practice is rated as inadequate.

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. However, reviews and investigations were not thorough enough.
  • Risks to patients were not well assessed nor well managed such as those relating to recruitment checks.
  • There were not enough staff to keep patients safe. The practice was managed by one GP and utilised regular locum cover.
  • There was limited recognition of the benefit of an appraisal process for staff and little support for any additional training that may be required
  • The security and recording systems around prescription pads and paper was inadequate.
  • Data showed patient outcomes were low compared to the national average.
  • Audits had been carried out which showed some evidence of driving improvements to patient outcomes.
  • The majority of patients said they were treated with compassion, dignity and respect.
  • The practice had a number of policies and procedures to govern activity, but some were overdue a review.

The areas where the provider must make improvements are:

  • Ensure safety incidents are investigated thoroughly and all incidents that should be are reported.
  • Ensure the practice recruitment policy and procedure include all required employment checks for all staff for example Disclosure and Barring checks
  • Ensure staff receive adequate training appropriate to their roles and appraisals.
  • Ensure effective communication systems are in place for people who need to know within the service.
  • Ensure practice procedures and guidance is reviewed and updated.
  • Ensure there are adequate health and safety policies and procedures that are practice specific and environmental risk assessments in place.
  • Ensure the complaints procedure is in line with recognised guidance and contractual obligations for GPs in England.
  • Ensure there are enough staff to provide consistent care and to increase capacity.

In addition the provider should:

  • Improve the security and recording systems around prescription pads and paper.
  • Provide staff with clarity of their roles and responsibilities.
  • Improve and monitor patient outcomes and assign leads to specific clinical and practice management areas.
  • Improve the way feedback is gained and monitored as there was no patient participation group (PPG) and there was very little response to the NHS Friends and family test (FFT). There were no recorded staff meetings and no evidence to show that the practice had gathered feedback from staff.
  • Improve the opportunity for patient feedback and consider the formation of a Patient Participation Group (PPG)
  • Make further efforts to identify patients registered who are also carers.
  • Develop a dedicated practice website

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 February 2014

During a routine inspection

We spoke with four people who used the service. They all told us that overall they were happy with the service they received. Comments included: 'I'm very happy, they are very good', 'They [reception staff] are really helpful and the doctors are brilliant', 'You've got that trust between you and them [the doctor]. That's what I like' and 'I trust them with my life.'

The practice had single consultation rooms and offered a chaperone service to promote people's privacy and dignity. People were given information about the services available.

The practice met with other health and social care professionals to ensure people were receiving care and support from appropriate services in order to improve their overall health and wellbeing.

Staff received appropriate training in adult safeguarding and child protection. They were able to identify the possible signs that abuse may be occurring.

Treatment rooms and the waiting area were clean and hygienic. Liquid soap, hand gel and paper towels were available in the treatment rooms and toilets. Hand washing guidelines were displayed in line with best practice requirements.

The practice undertook a range of audits and participated in the quality and outcomes framework system in order to monitor and assess the quality of the service they provided.