Archived: Sycamore House Medical Centre Also known as Drs. Dugas and Dhaliwal

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection visit of Sycamore House Medical Centre in March 2016. As a result of our comprehensive inspection the practice was rated as requires improvement for providing safe services and good for effective, caring, responsive and well-led. At this time we identified a breach of regulation around safe care and treatment. This was because the provider, in the absence of checks with the disclosure and barring service (DBS) did not ensure that appropriate risk assessments were carried out or ensure the completion of appropriate training for staff who acted as chaperones. As a result we identified areas where the provider must make improvement and some areas where the provider should improve.

Following the inspection the practice sent us an action plan detailing the actions they were going to take to improve.

We carried out this focussed desk based inspection of Sycamore House Medical Centre on 15 December 2016 to check that the provider had made improvements in line with our recommendations and to ensure regulations were now being met. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Sycamore House Medical Centre on our website at www.cqc.org.uk. Our key findings across all the areas we inspected were as follows:

• Since our comprehensive inspection which took place in March 2016, systems were now in place to ensure risks to patients were assessed and well managed. As part of our desk based inspection the management team provided evidence to demonstrate that appropriate checks with the disclosure and baring service had been carried out for staff. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). The practice had included oxygen along with adult and child masks to their equipment used to respond to a medical emergency.
• During our previous inspection staff who carried out chaperoning were not all trained for the role and were unable to demonstrate how they would carry out the role effectively. Staff had now received appropriate training and members of the nursing team were able to provide in-house training.
• When we inspected the practice in March 2016 we saw that the practice carers list was below 2%. The practice had now implemented a number of measures to improve the identification and support of carers. The practice now incorporated questions in the new patient registration form to help increase identification of carers and used social media to encourage patients to inform the practice if they were carers. As a result of the practice drive to identify carers’ data provided by the practice as part of our desk based inspection showed that the practice held a register of 19 carers; this equated to 0.44% of the patient population which was an increase of 0.25% since the previous inspection. The practice explained that they were continuing with efforts to ensure they identified and supported all carers registered as patients at the practice.
• For example, we were told that the lead GP carried out ward rounds at the local children’s hospice and provided information to raise awareness of various support services available within the community.
• The practice manager explained that eligible carers had access to annual health checks, flu vaccinations and a stress levels review. Data provided by the practice showed that 90% of patients who were carers had been offered a flu vaccination although some had declined or received this from an alternative healthcare provider; and 95% had a health review in the last 12 months.
• When we first inspected the practice we saw that the practice patient participation group (PPG) had a low number of members and information promoting the PPG was limited. The chair we spoke with as part of the previous inspection explained that the practice were exploring ways to increase patient engagement.
• Evidence provided as part of the desk based inspection showed that the practice launched a Facebook page, updated their web site where patients were able to access minutes from previous meetings. The web site also included a PPG expression of interest form to increase PPG members.
• As a result of actions taken by the practice there were nine active PPG members and the practice was working with the PPG chair and Clinical Commissioning Group with a view of signing up to the national association for patient participation (NAAP).
• Members of the management team provided examples of where the PPG have been involved in decisions about future development opportunities. For example, meeting minutes’ provided as part of the desk based inspection demonstrated that the practice was actively involving patients in the merger with Umbrella medical group by asking patients to comment on any concerns they had about merger. We also saw that the practice responded to patients request for information on the staffing structure by developing a flow chart of staff and their clinical skills to enable patients to become more aware of staff roles and responsibilities.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice