Archived: New Invention Health Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Invention Health Centre on 20 July 2016. Overall the practice is rated as Good. An inspection had been carried out on the 23 October 2014 and the provider was found to be in breach of legal requirements and was rated as Requires Improvement in the Safe domain. Following on from the October 2014 inspection, the practice wrote to us to say what they would do to meet the legal requirements. We undertook a focused inspection on 9 December 2015 to check that the practice had followed their plan and to confirm that they now met the legal requirements. We found that the action plan had not been completed. As a result, the practice was rated as inadequate in Safe, and warning notices were issued in relation to the outstanding actions. A follow up inspection was carried out on 3 June 2016 to review the actions the practice had taken in response to the warning notices and we found the practice had completed the actions identified.You can read all our inspection reports for this prcatice by selecting the 'all reports' link for New Invention Centre on our website at www.cqc.org.uk.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses and there was an effective system in place for reporting and recording significant events.
• The practice had strong, visible clinical and managerial leadership and staff felt supported by management.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had no information on display to encourage patients to identify themselves as carers and the practice did not actively identify carers or have information to advise carers of services and support available.
• The practice had made improvements to the building and room allocation to improve access for patients.
• Governance and risk management arrangements were in place and well managed. Opportunities for learning from incidents were shared with the staff.
• The practice was active in actioning identified areas for improvement of the building and infection control audits and we saw evidence of changes being made.
• Feedback from patients and staff suggested that the GP partners had made positive improvements and there was a sense of stability and continuity in care.
• The practice employed a pharmacist to ensure that patients’ medicines were reviewed on a regular basis and medicine audits and alerts were actioned accordingly.
• Patients said they were treated with compassion, dignity and respect and we staff were friendly and helpful and treated patients with kindness and respect.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The provider was aware of and complied with the requirements of the duty of candour.
• Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs. We saw evidence that multidisciplinary team meetings took place every two months.

However there were areas of practice where the provider should make improvements:

• Ensure that patient records are appropriately coded so that staff are able to identify carers and develop a register of carers.
• Continue to review the registers for patients with learning disabilities to ensure appropriate reviews are in place.
• Review the impact on the accessibility of appointments and telephone access and seek patients’ views on the practice closing for patient appointments during normal working hours.
• Consider how to further engage with patients in the patient participation group to offer guidance and support, and encourage new members to join.

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 focused inspection at New Invention Health Centre on 9 December 2015, following a comprehensive inspection on 23 October 2014 when the practice was rated as requires improvement for providing safe services. Following our inspection the provider submitted a plan of action for improvements.

We then carried out a focused inspection on 9 December 2015 to establish whether the necessary improvements had been made. We found that the practice had not completed the identified actions and accordingly we rated the practice as inadequate for providing safe services. There were no additional issues found at the time of this inspection.

As a result of this inspection we then issued warning notices in relation to Regulation 9 (person centred care) and Regulation 17 (good governance) of the health and Social Care Act 2008. The practice were required to make the improvements by 29 February 2016. [RA1]

We then carried out a focused inspection on 3 June 2016 to look specifically at the areas identified in the warning notices to see if improvements had been made.

This inspection will not change the quality ratings applied on 9 December 2015. They will be reviewed at the next comprehensive inspection.

The provider in place at the time of this latest inspection had recently taken over the contract for the practice on 1 April 2016 and had commenced improvements to the site. A new practice manager had been recruited to provide managerial support, support staff and provide advice about the day to day operations of the practice. The evidence at this inspection demonstrated that the provider had taken action to comply with the warning notice.

Our key findings across all the areas we inspected were as follows:

• Issues relating to carpets and sinks, identified in the infection control audit of May 2015, had been addressed in line with national infection control guidance.

• The practice employed a maintenance worker who was acting on the identified areas for improvement, for example updating the reception area.

• Seating in the waiting area was still in need of repair, but this had been organised and we saw evidence to confirm this.

• The practice employed a cleaning company to carry out daily cleaning of the practice and records were in place which demonstrated that a schedule of regular cleaning took place.

• An Equality Act audit had been completed and this had identified actions to improve facilities for patients with a disability. The providers were currently reviewing the plan and implementing the actions to improve the premises.

• Staff had completed role specific training identified by the practice as being a requirement for staff.

We found that the provider had complied with all the elements of the warning notice and had made the necessary improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice