The Care Quality Commission
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Archived: Abbey Meads Medical Practice

Overall: Good read more about inspection ratings

Elstree Way, Swindon, SN25 4YZ (01793) 706030

Provided and run by:
Abbey Meads Medical Group

Important: The provider of this service changed. See new profile

All Inspections

14 February 2018

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Abbey Meads Medical Group on 28 and 29 October 2014. We found breaches in the regulations relating to safe and well-led services, and the overall rating for the practice was requires improvement. The full comprehensive report for the October 2014 inspection can be found by selecting the ‘all reports’ link for Abbey Meads Medical Group on our website at www.cqc.org.uk.

We carried out a further announced comprehensive inspection of Abbey Meads Medical Group on 6 June 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 28 and 29 October 2014. At this inspection we found breaches in the regulations relating to safe, effective, responsive and well-led services. As a result of these findings, the overall rating for the practice continued to be requires improvement. The issues were:

  • The practice did not ensure there were systems in place to enable the registered person to assess, monitor and improve the quality and safety of the service and which ensured scrutiny and overall responsibility is held by the partners.
  • The practice did not maintain adequate records of decisions made and action taken by the partners in relation to their governance role.
  • The practice did not adequately assess the risks to the security of confidential information, medicines and equipment caused by working in a shared building and take appropriate steps to minimise these risks.
  • The practice did not ensure letters responding to patients complaints included information about how to escalate the complaints if they were not satisfied with the practice’ response.
  • Not all staff had received training essential to their role. For example, seven clinical staff had not received training on safeguarding children and vulnerable adults relevant to their role.

Following the inspection on 6 June 2017, the provider sent us an action plan that set out the actions they would take to meet the breached regulations. We then undertook an announced focused inspection on 14 February 2018 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 6 June 2017. For this reason we only rated the location for the key questions to which this inspection related. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

This report covers the announced follow-up inspection on 14 February 2018. We found the provider had made improvements since our inspection on 6 June 2017. The information we received enabled us to find the provider was meeting the regulations that it had previously breached for safe, effective, responsive and well-led services.

The comprehensive follow-up report for the June 2017 inspection can be found by selecting the ‘all reports’ link for Abbey Meads Medical Group on our website at www.cqc.org.uk.

Overall the practice is now rated as Good.

Our key findings were as follows:

  • The practice put systems in place to enable the registered person to assess, monitor and improve the quality and safety of the service. These systems ensured scrutiny and overall responsibility is held by the partners.
  • The practice recorded decisions made and action taken by the partners in relation to their governance role.
  • The practice adequately assessed the risks to the security of confidential information, medicines and equipment caused by working in a shared building and took appropriate steps to minimise these risks.
  • The practice ensured letters responding to patients complaints included information about how to escalate the complaints if they were not satisfied with the practice’ response.
  • All staff had received training essential to their role. This included training on safeguarding children and vulnerable adults relevant to their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

6 June 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Abbey Meads Medical Group on 28 and 29 October 2014. We found breaches in the regulations relating to safe and well-led services, and the overall rating for the practice was requires improvement. The full comprehensive report for the October 2014 inspection can be found by selecting the ‘all reports’ link for Abbey Meads Medical Group on our website at www.cqc.org.uk.     

This announced comprehensive follow up inspection was undertaken on 6 June 2017.

Overall the practice continues to be rated as requires improvements.  Our key findings across all the areas we inspected were as follows:

  • The practice had been going through a process of significant change as they worked to address a range of issues following the retirement of some key staff.
  • The practice had a clear strategy and supporting business development plan.
  • Two new partners who had joined the practice were not based at the practice and were directors of a company the practice had subcontracted some tasks to, including clinical governance. There was lack of clarity around the new governance structure and the practices relationship with the subcontractor.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, lessons learned were not communicated widely enough to support improvement.
  • Staff were aware of current evidence based guidance, including National Institute for Health and Care Excellence (NICE) best practice guidelines.
  • Not all staff had been trained to provide them with the skills and knowledge appropriate to their role.  For example, safeguarding training and triage training.
  • Results from the national GP patient survey showed patients 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. However, letters responding to patient complaints did not include information about how to escalate the complaint if they were not satisfied with the practice’ response.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.

We identified regulations that were not being met and the provider must:

  • Ensure there are systems in place to enable the registered person to assess, monitor and improve the quality and safety of the service and which ensures scrutiny and overall responsibility is held by the partners.
  • Ensure the practice maintains adequate records of decisions made and action taken by the partners in relation to their governance role.
  • Ensure they adequately assess the risks to the security of confidential information, medicines and equipment caused by working in a shared building and take appropriate steps to minimise these risks.
  • Ensure lessons learnt from complaints and significant events are communicated to all appropriate staff.
  • Ensure systems for the administration of medicines and vaccines are safe and that emergency medicines are in date and suitable to be used.
  • Ensure correspondence  responding to patients complaints includ information about how to escalate their complaint if patients were not satisfied with the practice’ response.
  • Ensure all staff receive safeguarding  training essential to their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 and 29 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

Abbey Meads Medical Group is a large practice providing primary care services to patients resident in Swindon. The practice has one main practice and two branches, Penhill Practice and Crossroads Practice, nearby. The practice has a patient population of approximately 21,200 patients of which about 15% are over 65 years of age. Patients can attend any of the practices for primary care services. It is a teaching practice for medical students and GPs specialising in primary care.

We undertook a scheduled, announced inspection at the main practice and Penhill Practice on the 28 and 29 October 2014. Our inspection team was led by a Care Quality Commission (CQC) Lead Inspector and GP specialist advisor. Additional inspection team members were a practice manager specialist advisor and a CQC observer.

The overall rating for the practice is requires REQUIRES IMPROVEMENT

Our key findings were as follows:

  • Staff were caring and treated patients with kindness and respect.
  • Patients were able to get an urgent appointment when they needed one. However the waiting times for routine appointments or appointments with a specific GP was three to four weeks.
  • Staff explained and involved patients in treatment decisions.
  • The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies.
  • The practice met nationally recognised quality standards for improving patient care and maintaining quality.
  • Patients were treated by suitably qualified staff.
  • GPs and nurses followed national guidance in the care and treatment provided.
  • The practice minimised patient risk through regular reviews of incidents and significant events. The practice responded to national patient safety alerts.
  • The practice had developed an advance care planning tool to record patients’ end of life choices.
  • The practice employed their own community mental health nurse to support patients with mental health needs.

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

The provider must:

  • Ensure administrative staff undertaking chaperone duties have a criminal records check via the Disclosure and Barring Service.
  • Ensure the practice recruitment policy is followed when recruiting staff. For example, ensuring the appropriate number of references have been received
  • Ensure there are systems to assess, monitor and address risks to standards of cleanliness and hygiene and the prevention of infection.

The provider should:

  • Review GP and nurse staffing levels to ensure adequate numbers of suitably experienced and trained staff are available to maintain a consistent level of service, patient safety and continuity of care.
  • Work towards a practice team culture which promotes co-operation and inclusiveness.
  • Ensure there is a system to review and action plans from patient surveys, significant events and complaints to demonstrate recommendations have been addressed.
  • Ensure there is a system to monitor that staff have read patient safety alerts.
  • Develop a system to ensure equipment such as scissors and wound closures are in date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 September 2013

During a routine inspection

On the day of our visit to Abbey Meads Medical Group we met with the practice manager and one of the GP partners. We spoke with six patients and with four members of practice staff.

Patients told us that they were treated with dignity and respect. One patient said "I feel safe with the GP's and nurses who have always treated me with dignity and respect'.

Most patients were happy with the care and treatment they received. One patient said 'the surgery is good and I feel it meets my needs'. Another patient said 'although the practice is a large one, they have managed to keep the village practice feel'. We also sent out feedback surveys to some patients. Four patients responded to say that they were not happy with the availability of appointments and they were unable see their regular GP. All of these patients told us that they found it difficult to book routine appointments and the wait for such an appointment was often three to four weeks.

Patients were protected from the risk of abuse because staff were able to identify and report signs of abuse and neglect.

Patients were protected from the risk and spread of infection because appropriate guidance had been followed.

Staff felt supported in their roles. Staff received training and support appropriate to their roles.

Patient views were sought and their responses were acted upon. The practice ensured appropriate management and processes were in place to protect the safety and welfare of their patients.