Cranleigh Gardens Medical Centre

This practice is rated as Good overall. (Previous rating December 2018 – Good overall with requires improvement for safe).

The key question at this inspection is rated as:

Are services safe? – Good

We carried out an announced focused inspection at Cranleigh Gardens Medical Centre on 10 April 2019 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in Regulation 13 HSCA (RA) Regulations 2014: Safeguarding service users from abuse and improper treatment. We had identified systems and processes should be implemented to provide staff with safeguarding training necessary for their role including vulnerable adults at risk of abuse and Prevent. We found the concerns had been resolved when we undertook a follow up inspection of the service on 10 April 2019.

During this inspection we reviewed areas where the provider should make improvements identified in our previous inspection (5 December 2018) and our key lines of enquiry for ‘Safe’. This report and supporting Evidence Table covers our findings in relation to these.

The full comprehensive report on the December 2018 inspection can be found by selecting the ‘all reports’ link for Cranleigh Gardens Medical Centre on our website at www.cqc.org.uk

At this inspection we found:

• The practice had clear systems, processes and practices to protect people at risk of or suffering from abuse or neglect.
• Staff have the necessary skills and competencies appropriate for their role to identify and raise safeguarding concerns.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. We found the practice’s necessary and statutory training for staff was in line with or above national guidance.
• Arrangements were in place to support and manage staff to deliver effective care and treatment such as clinical supervision for nurses and annual appraisal system for salaried GPs.
• The practice had taken action to improve cervical screening uptake rates and identify the number of patients with carer responsibilities.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Please refer to the detailed report and the evidence tables for further information.

We carried out an announced comprehensive inspection at Cranleigh Gardens Medical Centre on 5 December 2018. As part of our inspection programme we also visited the branch surgery: Westonzoyland Surgery on 3 December 2018.

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.

We found that:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus and embedded system of quality improvement at all levels of the organisation. Leaders worked with external health organisations locally and nationally to support high-quality person-centred care delivery.

The areas where the provider must make improvements are:

• Ensure patients are protected from abuse and improper treatment.

In addition to the above, the provider should:

• Complete annual appraisals for salaried GPs.
• Implement a formal system for clinical supervision for nursing staff.
• Take action to ensure all staff have received relevant and mandatory training such as dementia awareness, safeguarding training in line with national guidance including vulnerable adults at risk of abuse and Prevent.
• Fully document actions as an outcome of safeguarding meetings.
• Take action to improve cervical screening uptake rates.
• Take action to increase the number of carers identified at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.