Parkgate Medical Centre

We carried out an announced comprehensive inspection at Parkgate Medical Centre on 12 November 2019. This inspection was conducted to follow up on breaches of regulations identified at the 27 March 2019 inspection when the practice was rated as requires improvement overall..

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 have rated this practice as good overall and good for all population groups and requires improvement for providing safe services.

We rated the practice as requires improvement for providing safe services because:

• The practice did not have clear systems, practices and processes to keep people safe and safeguarded from abuse.

We rated the practice as for good for providing effective, caring, responsive and well led services because:

• The practice had made improvements in oversight of training and was able to show that staff had the skills and knowledge to carry out their roles and had received annual appraisals.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The overall governance arrangements had improved in respect of infection prevention and control and staff training.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The provider must:

• Ensure care and treatment is provided in a safe way to patients.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review and improve staff access to a practice specific safeguarding policy and staff awareness of the safeguarding lead.
• Review and improve documentation of assessment of risk if staff are to be considered for employment prior to all recruitment checks being received.
• Review and improve cervical smear uptake to meet the 80% target.
• Review and improve access to the updated complaints procedure for patients and staff.
• Review and improve completion of equality and diversity training.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Parkgate Medical Centre on 27 March 2019 as part of our inspection programme. Our last inspection of the Parkgate Medical Centre was in June 2015 when the practice was rated as Good.

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 have rated this practice as Requires improvement overall.

We rated the practice as requires improvement  for providing safe services because:

• Not all staff had received the appropriate level of safeguarding training or chaperoning training.
• Systems and processes to ensure appropriate standards of cleanliness and hygiene were not adequate. Staff had not had all the required training in infection prevention and control.

We rated the practice as for requires improvement for providing effective services because:

• The practice was unable to show that staff had the skills and knowledge to carry out their roles and there was a lack of evidence staff had received annual appraisals.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as good for providing responsive services because:

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

We rated the practice as requires improvement for providing well-led services because:

• The overall governance arrangements were not always effective in respect of infection prevention and control and staff training.

These areas affected all population groups so we rated all population groups as requires improvement.

The areas where the provider must make improvements are:

• Maintain appropriate standards of hygiene for premises and equipment.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review risks associated with the storage of liquid nitrogen and evidence these have been mitigated.
• Review and improve processes for disposal of sharps bins within the recommended three-month period.
• Review and improve checks of the emergency equipment in line with the Resuscitation Council UK recommendations.
• Review and improve the complaints procedure and information for patients to include information on how to contact the Parliamentary and Health Services Ombudsman (PHSO) to escalate a complaint if not satisfied with the practice response.
• Review and improve the practice's whistle blowing procedure in line with the NHS Improvement Raising Concerns (Whistleblowing) Policy.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care