The Village Medical Centre

Letter from the Chief Inspector of General Practice

This is a focused follow-up inspection of The Village Medical Centre for areas within the key questions safe and effective. We found the practice to be good in providing safe and effective services. Overall the practice is now rated as good.

GP Care Services Ltd acquired the The Village Medical Centre in February 2017 which was rated inadequate at a previous inspection in September 2016. The practice was then inspected on 20 June 2017. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection the practice had made significant improvements and was then rated requires improvement overall because within the key questions safe and effective areas were still identified as requiring improvement as the practice was not yet meeting requirements at that time.

• The provider did not have a system in place to record the collection of prescriptions for controlled drugs.
• They did not have a system in place to deal with unmatched blood tests in the clinical system.
• They did not have a formal process to discuss and share complaints and significant events.

The practice provided us with an action plan detailing how they were going to make the required

improvements.

The full comprehensive report following the inspection on the 20 June 2017 is available on our website at www.cqc.org.uk/location/1-3475114133

This focused follow up inspection on 29 September 2017 was to confirm the required actions had been completed and award a new rating in the domains of safe and effective.The improvements we found mean that the practice is now rated ‘good’ for being safe and effective and is now rated good overall. The practice is also rated as ‘good’ for its services to all population groups. Evidence provided on this inspection included:

• A policy for the collection of controlled drug prescriptions
• A protocol for unmatched laboratory reports
• Minutes of clinical and administration meetings
• Agendas of meetings showing standing items for discussion

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 20 June 2017.

GP Care Services Ltd acquired The Village Medical Centre in February 2017 which was rated Inadequate at a previous inspection in September 2016 when operated by another provider. The new provider has carried out significant improvements since taking over the practice and also recognise that they are on an improvement journey, with further improvements still required.

Following the inspection in September 2016 the practice was rated as overall Inadequate with the following domain ratings:

Safe – Inadequate

Effective – Inadequate

Caring – Good

Responsive – Requires improvement

Well led - Inadequate

At that time concerns were found in respect of:

• The registered person did not do all that was reasonably practicable to assess, monitor, manage and mitigate risks to the health and safety of service users. No risk assessments had been carried out in relation to health and safety, fire safety, infection control or legionella.
• Not all recruitment checks on staff had been undertaken prior to their employment and staff were not DBS checked.
• There were no records to show whether staff were immunised against infectious diseases.
• There were no clear records to show that staff had received mandatory training and staff acting as chaperones had not received training in the role.
• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.
• Patient outcomes were hard to identify as no reference had been made to audits or quality improvement.
• The practice had no clear leadership structure, insufficient leadership capacity, no day to day supervision and support of staff and no formal governance arrangements.
• There were no policies and procedures which had been personalised to the practice.
• There was no repeat prescribing policy available and no policy or process for dealing with safety alerts.

Following this inspection the practice is now rated as requires improvement

Our key findings across all the areas were as follows:

• GP Care Services Ltd had carried out a total refurbishment of two treatment rooms bringing them up to the required standards. Other improvements included work on the paths outside for patient safety and had a phase two refurbishment planned.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The provider had introduced clearly defined systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Patients we spoke with and completed CQC comment cards said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt strongly supported by GPs and management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvements are

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice