Ifield Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Ifield Medical Practice on 11 March 2015. We visited the practice location at Lady Margaret Road, Ifield, Crawley, West Sussex RH11 0BF.

Overall the practice is rated as requires improvement. Specifically, we found the practice to be good for providing caring and responsive services. It requires improvement for providing safe, effective and well led services. It also requires improvement for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• The practice understood the needs of the local population and planned services to meet those needs.
• The practice worked closely with external agencies and community services to meet the needs of patients and ensure continuity of care.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• 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.
• Staff had not always received training appropriate to their roles. Some staff had not received training in the safeguarding of children and vulnerable adults at a level appropriate to their role. Reception staff who acted as chaperones had not always received training to support this role.
• Learning from recorded incidents and clinical audit findings were not always reviewed and followed up to promote continuous improvement.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that all staff are trained in safeguarding of children and vulnerable adults at a level appropriate to their role.
• Ensure all staff acting as chaperones are appropriately trained for the role.
• Ensure the actions identified as a result of auditing of infection control processes are documented and reviewed so that progress and completion can be monitored.
• Ensure regular rehearsal of fire evacuation procedures within the practice in order to assess and monitor the risks associated with such an emergency.
• Ensure effective arrangements are in place to ensure the safe storage of prescription pads at all times, particularly when the practice is closed.

In addition the provider should:

• Establish a process to ensure more formal sharing of information and learning from incidents for all staff.
• Ensure learning points from incidents and audits are followed up and reviewed.
• Develop a programme of clinical audit and ensure audit cycles are completed to promote continuous improvement to patient care.
• Provide regular opportunities for nurses and GPs to meet to reflect on clinical practice and best practice guidance.
• Ensure that all staff who require a DBS checks have received one, including those staff undertaking chaperone duties.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice