Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Vine Medical Centre on 15 December 2015. The practice was rated as requires improvement in safe, effective, responsive and well-led. They were good in caring. We carried out a further announced comprehensive inspection on 13 June 2016. The practice is rated as inadequate in well-led, good in safe, effective and caring and requires improvement in responsive. They are rated as requires improvement overall.
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.
- Risks to patients were generally assessed and well managed. However, the practice had not carried out regular portable appliance safety checks or undertaken a risk assessment relating to this.
- The practice had made improvements in relation to infection control and medicines management processes since their previous inspection in December 2015.
- Data showed patient outcomes were comparable to the national average. There was evidence of audits being carried out and used to drive improvements to patient outcomes.
- The majority of patients said they were treated with compassion, dignity and respect. Patient feedback was positive in relation to people’s experience of care and national survey results reflected this in terms of patient’s involvement in their care planning and decisions.
- The practice had developed practice based services jointly with other providers such as diabetic and vascular clinics.
- A practice nurse had developed a respiratory support group for patients with respiratory conditions.
- The practice had procedures in place for managing complaints, however the review and subsequent learning from complaints was not sufficient.
- The practice had a number of policies and procedures to govern activity, but there was not a clear process in place for the ratification and adoption of policies within the practice. Some policies were overdue a review and others had been adopted from external sources without being localised to the needs of the practice.
- A lack of overarching governance framework within the practice had been identified during inspection in December 2015. This was found to still be the case in relation to policy management and the management of records relating to this and recording meeting minutes.
The areas where the provider must make improvements are:
- Ensure that electrical appliances are safety checked on a regular basis and that decisions as to the timeliness of checks are formed as part of an assessment of risk.
- Ensure that complaints are managed in line with the practice policy and that reviews of complaints are held with clear records of identified trends, lessons learned and actions taken as a result to improve patient experience.
- Ensure there is a comprehensive system for the ratification, adoption and update of practice policies and that all staff are aware of this process.
- Ensure that minutes of meetings are being appropriately recorded with clear decisions and action points.
In addition the provider should:
- Ensure that appropriate positive action is taken regarding patient concerns about getting through to the practice by phone.
- Ensure that the patient participation group is effective in improving services for patients.
Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice