The Village Medical Centre

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection in February 2016 found breaches of regulations relating to the effective, responsive and well-led delivery of services.

Following the February 2016 inspection The Village Medical Centre was requires improvement for the provision of effective, responsive and well-led services. The practice was rated good for providing safe and caring services. Consequently we rated all population groups as requires improvement.

This inspection in October 2016 was undertaken to ensure improvements had been implemented and that the service was meeting regulations. For this reason we have only rated the location for the key questions to which these relate. This report should be read in conjunction with the full inspection report of 24 February 2016.

During the October 2016 inspection, we found the practice had made some improvements since our last inspection. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective and caring services. However, the practice is required to make further improvements and remains rated as requires improvement in the responsive and well-led domains. Consequently we have rated all population groups as requires improvement.

Specifically we found:

• The practice had taken steps to improve the appointments booking system. However, 73% patients we spoke with on the day of inspection informed us they had not seen any significant improvement in the last six months and they had to wait a long time to get through to the practice by telephone.
• The practice had not taken all actions in a timely manner and it was therefore too early to assess the impact of improvements planned, for example, installation of new telephone system.
• The practice had not routinely monitored telephone calls data, carry out an internal survey or an audit since the previous Care Quality Commission (CQC) inspection in February 2016 to find out whether patients were satisfied with their access to care and treatment.
• The practice had tried to engage with inactive patient participation group (PPG). However, they were not fully successful and required to review their approach to promote patient participation in PPG.
• All clinical and non-clinical staff had received training relevant to their role.
• The practice had updated their registration with CQC.
• During the current Quality and Outcomes Framework (QOF) year 2016-17, the practice had demonstrated improvements in patient’s outcomes for patients with diabetes and patients experiencing poor mental health.
• The practice had taken steps to promote the benefits of national screening programme and demonstrated improvement in patient outcomes for cervical screening.

The areas where the provider must make improvements are:

• Review and monitor the appointments booking system and the waiting time it takes to get through to the practice by telephone.
• Ensure feedback from patients through the PPG is sought and acted upon.

In addition the practice should:

• Ensure extended hours appointments details are advertised on the practice website.
• Review the process of identifying carers to enable them to access the support available via the practice and external agencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Medical Centre on 24 February 2016. Overall the practice is rated as requires improvement.

Specifically, we found the practice to require improvement for provision of effective, responsive and well led services. It was good for providing safe and caring service. The concerns which led to these ratings apply to all population groups using the practice.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded.
• Risks to patients were assessed and well managed in some areas, with the exception of those relating to infection control training. For example, all clinical and non-clinical staff had not undertaken annual infection control training.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Most staff had the skills, knowledge and experience to deliver effective care and treatment. However, most staff had not completed health and safety, equality and diversity, and fire safety training.
• 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.
• Patients said they found it difficult to make an appointment with a named GP and had to wait a long time to get through to the practice by telephone each morning. Urgent and online appointments were available the same day.
• The practice had excellent facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvements are:

• Ensure all staff have undertaken training including infection control, health and safety, equality and diversity and fire safety.
• Further review the appointments booking system and the waiting time it takes to get through to the practice by telephone. Improve the availability of non-urgent appointments with a named GP.
• Ensure feedback from patients through a patient participation group (PPG) is sought and acted upon.

In addition the practice should:

• Review and improve the systems in place to effectively monitor patients experiencing poor mental health and diabetic patients.
• Review the system in place to promote the benefits of cervical, bowel and breast screening, smoking cessation and flu vaccination in order to increase patient uptake.
• Take action to review their approach and support for patients with carers responsibility.
• Provide practice information in appropriate languages and formats.
• Ensure that within response to complaints patients are given the necessary information of the complainant’s right to escalate the complaint to the Ombudsman if dissatisfied with the response.
• Ensure extended hours appointments and online appointments details are advertised on the practice website and displayed in the premises.
• Ensure provider address and partnership details are updated to the practice’s Care Quality Commission registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice