Letter from the Chief Inspector of General Practice
We completed a comprehensive announced inspection at Khan Medical Centre on 15 October 2014.
Specifically, we found that the practice was effective, and responsive. However, it required improvement for providing a safe, caring and well-led service. We also inspected the quality of care for six population groups these are, people with long term conditions, families, children and young people, working age people, older people, people in vulnerable groups and people experiencing poor mental health. We rated the care provided to the six population groups as requires improvement. We rated the practice overall as requires improvement.
Our key findings were as follows:
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Systems were not in place to ensure that significant events and complaints were suitably recorded, monitored and there was insufficient evidence to demonstrate learning outcomes.
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Patients told us that the GP listened to what they had to say and discussed their health needs with them. Staff were seen to be caring and treated patients with dignity and respect.
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Systems and processes to manage risks to patient's safety were not in place or sufficiently robust. For example
reviews of the premises, equipment, recruitment and the business continuity plan.
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Data showed patient outcomes were average for the locality. Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
However, there are also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
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Implement effective systems to ensure patients and others are protected against the risks of receiving inappropriate or unsafe care or treatment. This should include the management of emergency situations, the premises, equipment, staffing and recruitment.
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Ensure that recruitment processes are robust and followed by the practice. Sufficient and suitable pre-employment checks must be undertaken for all staff, including locum GPs.
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Develop processes to ensure that infection prevention and control procedures are adhered to, for example the cleaning or replacement of curtain screening in line with the Health and Social Care Act 2008, Code of Practice on the prevention and control of infections and the cleaning of equipment with records to demonstrate that cleaning has been completed. Ensure that staff training is up to date.
In addition the provider should:
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Information should be freely available to patients regarding the process for making a complaint and who to refer to if they are not satisfied with the practice’s handling of the complaint or the outcome.
Ensure that the whistleblowing policy gives sufficient information to enable staff to raise concerns external to the practice, if necessary.
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Review computer records regarding children registered at the practice who have a child protection plan to ensure information is up to date.
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Ensure staff have a clear understanding of their role and responsibility in regard to Gilick competencies,
the safeguarding of vulnerable adults and children and the Mental Capacity Act 2005.
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Ensure that
vaccine fridge temperatures are monitored on a daily basis and provide evidence to demonstrate that vaccinations are stored within the appropriate temperature range for safe storage of medication.
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Ensure that all equipment at the practice receives the necessary maintenance and checks and provide records to demonstrate this, for example portable appliance testing and calibration of equipment.
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Ensure that issues identified at staff appraisal and recorded on their performance reviews are addressed or provide evidence why the needs have not been addressed.
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The practice should put systems in place to identify patients at the practice with caring responsibilities; this could include an alert on the practice’s computer system in order to enable staff to better support this group of patients.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice