Washwood Heath Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Washwood Heath Centre on 14 November 2016. Overall the service is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

• We observed the premises to be visibly clean and tidy and there was a named infection control lead for staff to report infection control concerns and seek best practice advice and guidance from.

• There was an open and transparent approach to safety and a system in place for recording, reporting and acting on significant events. However, the learning from these was not shared with all staff.

• Most risks to patients were assessed and well managed. A system was in place to share patient safety and medicine alerts with members of staff but these were not shared effectively with regular locum staff. The service did not have access to shared databases so that patient records could be checked or information shared in a timely way to promote effective care and treatment. If required, staff phoned through to the patients’ own GP or other health services and information was sent or received by secure methods such as by fax.
• Patients’ care needs were assessed and care delivered on a priority basis through a red alert triage system. There were good facilities and the service was well equipped to treat patients and meet their needs.
• The service monitored changes in relevant evidence based guidance and standards including National Institute for Health and Care Excellence (NICE) best service guidelines
• Staff had the relevant skills to assess patients’ needs and had access to appropriate training. However, the system in place to assess staff competence and provide assurance that high standards were maintained was not fully effective.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services to reduce hospital admission where appropriate and improve the patient experience.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on. However, there was scope to strengthen the patient survey to include targeted questions about the patient experience.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Establish an effective system to share key learning and patient safety information with long term locum staff following significant events and patient safety and medicines alerts.

• Ensure that systems used for patient feedback gather information about the quality of patient's experience so that the delivery of the service can be monitored and relevant improvement completed. 

• Ensure there is an appropriate induction process for any long term locum staff so that they receive relevant information and regular supervision in order to work effectively with patients.

• Establish an effective process for the supervision of the advanced nurse practitioners to ensure their competence is maintained in order to achieve the best outcomes for patients.

The areas where the provider should make improvements are:

• Review the risks in relation to the waiting area where staff have limited visibility of patients who could deteriorate whilst waiting to be seen.

• Review access to information in alternative languages to suit the needs of the local population. This should include information on accessing the complaints process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice