Archived: Medway NHS Healthcare Centre

We carried out an announced comprehensive inspection at Medway NHS Healthcare Centre on 10 July 2018. The overall rating for the practice was good. However, the practice was rated requires improvement for providing safe services and a Requirement Notice was served in relation to breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 12 Safe care and treatment, found at this inspection. The full comprehensive report on the July 2018 inspection can be found by selecting the ‘all reports’ link for Medway NHS Healthcare Centre on our website at www.cqc.org.uk.

After our inspection in July 2018 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the Requirement Notice served.

This inspection was an announced focussed follow-up inspection carried out on 23 October 2018 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 10 July 2018. This report only covers findings in relation to those requirements.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

This practice remains rated as good overall and is also now rated as good for providing safe services.

At this inspection we found:

• Improvements to the arrangements for managing medicines in the practice kept patients safe.
• We saw that yellow bins, used to store clinical waste outside of the practice, had been made safe.
• The practice had reviewed the contents of the GPs’ home visit bag, which now contained sufficient appropriate equipment.
• Records showed that improvements had taken place to the recording of peak flow results established during respiratory reviews in individual patient records.
• The practice had continued to monitor and improve patient uptake for breast and bowel screening.
• The practice had continued to monitor and improve national GP patient survey patient satisfaction scores.
• Governance documents that we looked at were kept up to date.

Whilst we found no breaches of regulations, the provider should:

• Continue to monitor and improve patient uptake for breast and bowel screening.
• Continue to monitor and improve national GP patient survey patient satisfaction scores.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Medway NHS Healthcare Centre on 10 July 2018 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• There was an effective system for reporting and recording significant events.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The arrangements for managing medicines in the practice did not always keep patients safe.
• The practice routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• The practice had systems and processes for learning, continuous improvement and innovation.
• There was a focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Consider improving the way yellow bins, used to store clinical waste outside of the practice, are made safe.
• Consider reviewing the contents of the GPs home visit bags, in order to ensure they contain sufficient appropriate equipment.
• Consider improving the recording of peak flow results established during respiratory reviews in individual patient records.
• Continue to monitor and improve patient uptake for breast and bowel screening.
• Continue to monitor and improve national GP patient survey patient satisfaction scores.
• Ensure all governance documents are kept up to date.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.