Greengates Medical Group Also known as Greenwood Avenue & Minstergate Surgeries

At this inspection we followed up on should improves identified at a previous inspection on 21 June 2019 when the practice was rated requires improvement for the well led key question. The report on the June 2019 inspection can be found by selecting the ‘all reports’ link for Greengates Medical Group on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 December 2019 to confirm that the practice had taken action to address the improvements required. This report covers our findings in relation to those requirements.

At the last inspection in June 2019 we rated the practice as requires improvement for providing well led services because the practice needed to:

• Review and improve the consistency of infection, prevention and control processes across all sites.
• Review and improve the system for completion and monitoring of mandatory training.
• Review and improve the cohesiveness for working across the practices’ five sites.

At this inspection, we found that the provider had satisfactorily addressed these areas.

We based our judgement of the quality of care at this service is on a combination of:

• what we found when we inspected.
• information from our ongoing monitoring of data about services and
• information from the provider and other organisations.

The practice is now rated as good as good for well led.

Our key findings were as follows:

• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

At this inspection we followed up on breaches of regulations identified at a previous inspection on 21 November 2018. The overall rating for the practice was requires improvement. The full comprehensive report on the November 2018 inspection can be found by selecting the ‘all reports’ link for Greengates Medical Group on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 June 2019 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 on 21 November 2018. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

At the last inspection in November 2018 we rated the practice as requires improvement for providing safe services because:

• Recruitment files lacked information.
• Infection and prevention control standards were not adequate.
• Equipment testing was not consistent.
• We saw evidence of delays in urgent referrals.
• Safety alerts were not being recorded and actioned sufficiently.
• Blank prescriptions were not being stored securely.

At this inspection, we found that the provider had satisfactorily addressed these areas.

At the last inspection in November 2018 we rated the practice as requires improvement for providing well led services because:

• Appraisals were not up-to-date.
• There was a lack of overarching governance.
• Incident investigation needed improvement.
• Fire risks had not been sufficiently addressed.

We found that some improvements had been made in the well led key question, however further improvement was required therefore the rating remains requires improvement.

We based our judgement of the quality of care at this service is 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.

The practice is now rated as good.

Our key findings were as follows:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

The provider should:

• Review and improve the consistency of infection, prevention and control processes across all sites.
• Review and improve the system for completion and monitoring of mandatory training.
• Review and improve the cohesiveness for working across the practices’ five sites.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

This practice is rated as Requires improvement overall. (Not previously rated)

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? - Requires improvement

We carried out an announced comprehensive inspection at Greengates Medical Group on 21 November 2018. This was done as part of our inspection programme.

At this inspection we found:

• The practice lacked clear systems to manage risk and safety incidents.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff treated patients with compassion, kindness, dignity and respect. Patients told us they were happy with the care they received.
• Patients reported that they were able to access care when they needed it.
• There was a lack of overarching governance within the organisation.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review and improve the locum GP pack, to enable locum GPs to effectively carry out their duties at the practice.

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.