Springfield Primary Care Centre

Background to this inspection

Updated 15 September 2017

Springfield Primary Care Centre is a small practice located between Stockwell and Clapham North, in the London Borough of Lambeth. The practice list size is approximately 6650. The practice population is diverse, with a large number of patients from Spain and Portugal. Life expectancy for males in the practice is 76 years and for females 81 years. Both of these are in line with the Lambeth CCG and national averages for life expectancy. The practice population is in the third most deprived decile in England. The practice has a higher than average number of male and female patients aged between 24 and 44 years. The practice has lower than average numbers of both male and female patients aged 50-85 years old.

The practice is based over two floors. Facilities include eight consultation rooms, two treatment rooms and two patient waiting rooms (one on the ground floor, one on the first floor). Patients with mobility problems are always seen on the ground floor. The premises are wheelchair accessible and there are facilities for wheelchair users including a lift and accessible toilets and a hearing loop. Other facilities include baby changing facilities and wheelchair accessible toilets.

The staff team compromises of two GP partners one male and one female partner, and one female salaried GP. One partner works seven sessions a week, the other partner and salaried GP each work six sessions a week. Other staff include one practice nurse, a health care assistant, five receptionists, three administration staff, and a practice manager.

The practice is open between 8.00am to 6.30pm Monday to Friday. It offers extended hours from 6.30pm to 8.00pm on Tuesdays. Appointments are available to patients from 8.30am to 6.10pm Monday to Fridays. Appointments are also available during the extended hours from 6.30pm to 7.45pm. When the practice is closed patients are directed (through a recorded message on the practice answer machine) to contact the local out of hour’s service. Information relating to out of hour’s services is also available on the practice website. This includes details of the local walk in service and pharmacy services.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury; diagnostic and screening; maternity and midwifery services and surgical procedures. The practice has an Alternative Provider Medical Services (APMS) contract (APMS contracts are provided under Directions of the Secretary of State for Health. APMS contracts can be used to commission primary medical services from traditional GP practices).

Overall inspection

Good

Updated 15 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Springfield Primary Care Centre on 14 September 2016. The overall rating for the practice was requires improvement. Breaches of legal requirements were found relating to the Safe and Responsive domains. The provider did not have an effective system or process to make sure they assessed and monitored the service provided. For example, there was not an effective system in place for managing safety alerts. There was no second thermometer for all vaccine and medicine fridges in the practice. Also the practice did not ensure that persons employed by them received such appropriate support, training, professional development, supervision and appraisal as was necessary to enable them to carry out the duties they were employed to perform. For example: all staff records did not have details of up-to-date mandatory training, for example basic life support. Additionally the practice was not responsive to patient access and involvement in relation to the GP Patients’ survey responses.

After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulation 17 (Good governance) and regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report can be found by selecting the ‘all reports’ link for Springfield Primary Care Centre on our website at www.cqc.org.uk.

This inspection was a document-based review carried out on 3 August 2017 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 in our previous inspection on 14 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good

Our key findings were as follows:

All staff had completed basic life support training; we saw certificates for all staff members to demonstrate this.
The practice had purchased a second thermometer for the medicine refrigerator. We saw photographic evidence. We also saw the health care assistant checked calibration monthly.
The chaperone policy had been reviewed in May 2017, we saw certificates for “chaperone and consent” training for all staff who undertook chaperone duties.
The practice had reviewed its policy on obtaining references for new staff. We saw a revised policy, and a completed reference form for the one new member of staff who had been recruited since the last inspection.
Since the initial inspection, the practice had reviewed its protocol for recording details about patients with caring responsibilities and had identified a new search to identify carers. As a result, the number of patients recorded as carers on their clinical system had increased from 4 patients (approximately 0.06%) to 161 patients (approximately 2%). We also saw evidence of how the primary care navigator (a member of staff that provides support for carers) sign posted carers.
There was a clear system in place to identify safety alerts and action taken as a result of safety alerts. We saw a policy that had been reviewed in October 2016; we saw a comprehensive spread sheet detailing dates, alerts, recommendation and action taken if the alert impacted on patients. We also saw minutes from clinical team meetings where safety alerts were discussed.
The practice had reviewed the GP patient results; we saw evidence that this was discussed in an all staff meeting. We saw the practice had created their own survey to identify how they could improve patient access, and we also saw an action plan as a result of the GP patient survey and the practice’s own survey.
There was a clear system for ensuring suitable records of meeting discussions, action points and outcomes were accessible to all staff. We saw comprehensive minutes, with actions and outcomes stored on the shared drive.

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

Importantly, the provider should:

Continue reviewing how to respond to patient access and involvement in relation to the GP Patients survey responses. Whilst GP patient survey had improved after the inspection, the most recent data demonstrated the figures had declined.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice