This practice is rated as good overall.
(Previous inspection 5 and 8 September 2017- Inadequate.)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Park Grange Medical Centre on 5 and 8 September 2017. The overall rating for the practice at that time was Inadequate. The full comprehensive report on the September 2017 inspection can be found by selecting the ‘all reports’ link for Park Grange Medical Centre on our website at www.cqc.org.uk.
Following the inspection on 5 and 8 September 2017, we applied an urgent condition to the providers’ registration. The provider was told they must not use the recently constructed extension to the practice without the prior written agreement of CQC, which would only be given after they had provided adequate proof that the extension met Regulation 12 (1) (2) (d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The actions taken by the provider were reviewed in detail during an inspection on 7 March 2018 and a separate report was produced. The provider was able to evidence compliance with the condition imposed on their registration and the condition was removed.
This inspection was an announced comprehensive inspection carried out on 2 and 3 May 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 5 and 8 September 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.
At this inspection we found:
- The practice had implemented clear systems and processes to manage risk so that safety incidents were less likely to happen. We saw evidence that when incidents did happen, the practice reviewed these as a team, learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided and used technology to support this. It ensured that care and treatment was delivered according to evidence- based guidelines.
- There were up to date, comprehensive risk assessments in relation to safety issues.
- The practice had completed all the works required relating to the extension of the practice. A certificate evidenced that works had been completed to the required standards.
- Patients told us they were treated with compassion, kindness, dignity and respect.
- Results of the July 2017 GP patient survey data showed patients did not always find the appointment system easy to use. However, feedback from patients and data collected by the practice since this time did not align with this view.
- There was a strong focus on management oversight, innovation, improvement and continuous learning and at all levels of the organisation.
- A clinical and non-clinical lead had been appointed to manage infection prevention and control (IPC). Staff were up to date with IPC training, an audit had been completed and an action plan was in place. Cleaning schedules had been implemented for clinical equipment and clinic rooms.
- The practice was able to describe how it had developed its cultural competence to address the needs of its diverse population. For example, ensuring timely completion of documentation following a patient death to facilitate religious burial timeframes, and the proactive review of medicines and advice during periods of fasting.
We saw one area of outstanding practice:
- One of the GP partners was interested in how technology could assist to improve and deliver safe and effective patient care. A number of templates, safety nets and processes had been developed within the computer systems; which allowed clinicians to complete referrals letters, prescribe safely and carry out thorough and comprehensive reviews to a high standard directly from the patient record. The safe and innovative system automatically pre-populated patient information, reducing human error, time and delays.
The areas where the provider should make improvements are:
- The provider should continue to review and take steps to improve the uptake of screening at the practice, including breast, bowel and cervical screening.
- The provider should continue to review and respond to the results of patient satisfaction surveys and ensure that they can meet the needs of their patient population in the future.
I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service. These improvements now need to be sustained, moving forwards.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice