We carried out an announced focused inspection at Denton Turret Medical Centre on 11 January 2019. This was as part of our ongoing inspection programme and to check the practice had made the improvements CQC said they should when we last inspected the practice in April 2018.
At the last inspection in April 2018 we rated the practice as requires improvement for providing safe services because:
- Improvements were needed to ensure the practice had adequate systems to assess, monitor and manage risks to patient safety.
- Their approach to learning from incident and near misses was limited as not all staff were supported and encouraged to identify incidents that the practice could learn from.
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 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.
We rated this practice as good overall. (Previous rating April 2018 – Good). We rated the practice as good for providing safe services because:
- They had implemented a record of staff immunity levels for mumps, chickenpox and rubella in line with national guidance.
- They had carried out test fire evacuations.
- They had improved their approach to identifying and learning from significant events.
In April 2018, we told the provider they should continue with the planned programme of staff appraisals to ensure all staff benefit from these support meetings at least annually. In January 2018, we found all staff employed for over a year had received an appraisal within the last year.
We also told the practice in the April 2018 inspection that they should review the arrangements for encouraging and acting upon feedback from the patient participation group. We spoke with members of the current group, who told us they were satisfied with the arrangements in place and the practice responded to and acted upon their feedback. The group was small (with three members) and the practice manager told us they had taken action to encourage new members to join, but no new members had yet come forward.
In April 2018, we also noted the practice was slightly lower on their satisfaction scores within the National GP Patient Survey (published July 2017) on consultations with GPs and nurses. However, they were not a statistical outlier on these indicators. In the survey results published in July 2018, the practice was still slightly lower than average on indicators relating to how doctors and nurses provide services with kindness, respect and compassion (National GP Patient Survey data published July 2018). As in the previous year, the practice was not a statistical outlier for these indicators. For example:
- The percentage of respondents to the GP patient survey who stated that the last time they had a general practice appointment, the healthcare professional was good or very good at listening to them was 83.5% (CCG average 91.3%, England 89.0%).
- The percentage of respondents to the GP patient survey who stated that the last time they had a general practice appointment, the healthcare professional was good or very good at treating them with care and concern was 79.7% (CCG average 90%, England 87.4%).
- The percentage of respondents to the GP patient survey who stated that during their last GP appointment they had confidence and trust in the healthcare professional they saw or spoke to was 93.1% (CCG average 96.6%, England 95.6%).
- The percentage of respondents to the GP patient survey who responded positively to the overall experience of their GP practice was 83.8% (CCG average 87%, England 83.8%).
The practice told us they were encouraging clinicians to fully engage patients in discussions about their health. Clinicians recorded this on the patient record. The practice told us they had carried out analysis of this, which showed the number of times clinicians had recorded ‘shared decision making’ during a consultation had increased from 24 for the year to 30 September 2018 to 311 by end of December 2018. The practice had not carried out their own survey of the views of patients to check if those improvements had yet impacted on patient satisfaction levels.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice