Archived: Wembley Park Drive Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wembley Park Drive Medical Centre on 30 March 2016. The overall rating for the practice was good, however the practice was rated requires improvement for safe. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for Wembley Park Drive Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 11 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 30 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall, the practice remains rated as good. At our previous inspection on 30 March 2016, we rated the practice as requires improvement for providing safe services as the practice did not have effective monitoring processes in place to ensure there were no gaps in mandatory staff training, as not all staff had received fire safety training and safeguarding training. We also found the practice did not have effective processes in place to ensure that there were no gaps in recruitment records for newly employed staff. Additionally, the practice did not ensure that all smart cards were securely stored when staff left their rooms. The practice is now rated as good for providing safe services.

Our key findings were as follows:

• Risks to patients were assessed and managed with the exception of recruitment checks, keeping medical records secure and mandatory training.

In addition, at the previous inspection we identified a number of areas where improvements should be made. These were as follows:

• Review the national GP patient survey scores with the aim of improving patient satisfaction scores on nurse’s involvement in care.

• Ensure all staff have an understanding of the practice mission statement.

• Ensure all staff have an understanding of the duty of candour policy.

At this inspection we found improvements had been made:

• All staff had completed fire safety and safeguarding training since the previous inspection.

• Smart card notices had been applied to all computers to alert the staff to remove their cards from their computer when not in use.

• The practice had recruited a new practice nurse and the two of the practice nurses were undergoing extensive training to improve their knowledge and skills.

• The practice had incorporated their mission statement as part of their New Staff Welcome Pack

• The practice had introduced a duty of candour training module into their annual mandatory training schedule.

• Although some improvements had been made to ensure there were no gaps in recruitment records, we still found that one newly recruited clinical member of staff only had one reference requested instead of two as per the practice recruitment policy.

In addition to addressing the breaches of regulation which impacted on safety, the practice had taken additional action on the basis of our last report:

• They had carried out improvement work to the patient toilets.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider should:

• Review staff recruitment files and ensure they are in accordance with policy.

• Continue to review the national GP patient survey results with the aim of improving patient satisfaction for nurse’s involvement in care.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice