Archived: Guttridge Medical Centre

This practice is rated as Good overall. (Previous rating January 2018 – Good)

The key question at this inspection is rated as:

Are services well-led? - Good

We carried out an announced focused inspection at Guttridge Medical Centre (Dr Shahid Surgery) on 24 October 2018 to follow up the breach of regulation 17, Good governance, identified at our inspection in January 2018 and to see whether our recommendation for improvement at our January inspection had been addressed. At the time of this inspection, the principal GP had been absent for some time and care for patients was being provided primarily by a regular locum GP. We inspected evidence relating to the Well-led key question.

At this inspection we found:

• The practice had begun to identify and manage the risks associated with historical patient clinical care. Patient prescribing was under review and changes had been made to reflect best practice.
• We saw evidence of good patient record-keeping although reasons for changes to patient medicines were not always recorded.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had improved the identification of patients on the register who were carers and offered them the appropriate support. They had identified 30 patients as carers (1.3% of the practice list) at the time of our inspection.
• Governance of the practice had improved and additional systems to manage risk in the practice had been identified and put in place.
• The organisation of practice policies and procedures had improved although further work to avoid duplication of policies was needed.

The areas where the provider should make improvements are:

• Improve the management of practice policies and procedures.
• Take action to record reasons for changes to patient medicines and treatment on patient clinical records.

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

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Guttridge Medical Centre (Dr Shahid Surgery) on 13 June 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for Guttridge Medical Centre (Dr Shahid Surgery) on our website at www.cqc.org.uk.

Following our inspection in June 2017 we rated the practice as requires improvement for providing safe, effective, responsive and well-led services and as requires improvement overall. We issued three requirement notices in relation to safe care and treatment, good governance and fit and proper persons employed by the practice.

This inspection was an announced focused inspection carried out on 11 January 2018 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection on 13 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• The practice generally had clear systems to manage risk so safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However, there was no system in place to identify the risk of having incomplete patient clinical records and we saw records for one GP lacked detail and did not follow best practice guidance for record-keeping.
• Staff and GP training was up-to-date; however, we saw the outcome of GP training was not always assessed to ensure it was effective.
• We saw patient safety had been improved since our inspection in June 2017. There was better governance of vaccine storage, the security of prescriptions and staff recruitment.
• The arrangements for managing medicines in the practice generally kept patients safe; however, the practice had failed to inform patients of the risks associated with prescribing a particular medicine for use other than the one it was licenced for.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. There was an improved programme of clinical audit since our last inspection.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported they were able to access care when they needed it.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• Following our last inspection in June 2017, the practice had taken steps to encourage patients who were carers to identify themselves to staff. They had appointed a carers’ champion and introduced a carers’ noticeboard in the patient waiting area. They had been helped by the local carers’ support service and there were plans for a member of this service to attend the practice every other month to promote the service to carers. The practice so far had identified 0.6% of the practice list as carers.

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

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• Continue to improve the identification and support for patients who are also carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice