Archived: Viran Medical Centre

This practice is rated as Good overall. (Previous rating 14/03/2018 – Requires Improvement)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services well-led? – Good

We carried out a comprehensive inspection of Viran Medical Centre on 14 March 2018. The overall rating for the practice was requires improvement with both key questions safe and well led rated as requires improvement. The full comprehensive report on the 14 March 2018 inspection can be found by selecting the ‘all reports’ link for Viran Medical Centre on our website at  www.cqc.org.uk.

This focussed inspection was carried out on 11 September 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach identified in the requirement notice.

Our key findings were as follows:

The practice had clear systems and processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

We saw one area of outstanding practice:

The practice had developed new protocols to manage all patients judged to be at risk which included a tool to identify vulnerable children, a policy to follow up children who had not attended appointments and a holistic assessment for patients with sensory impairment or who were carers for others. These protocols triggered alerts on patient records and multiagency discussion to ensure all staff who had contact with them could take appropriate action. All patients with any safeguarding risk had been reviewed since the last inspection and the practice monitored a spreadsheet of their status. The practice had regular contact with health visitors and school nurses and had been invited into a school to discuss the health and welfare of a pupil. Safeguarding was discussed at each monthly staff study day. The patient electronic health record coding team had reviewed the coding of vulnerable patients and the coding protocol had been audited to ensure it was accurate.

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 Viran Medical Centre on 14 March 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• There were established systems in place to manage and monitor risks to patients, staff and visitors. This included risks to the building, environment, medicines management, staffing, and emergency medicines. However emergency equipment was not routinely checked.

• Some systems did not reflect the status of patients, correspondence had not been filed and pathology results were awaiting action. All of these issues were corrected within hours of the inspection ending.

• The practice routinely reviewed the quality, effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence-based guidelines.We saw that a number of clinical audits had been carried out.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Staff understood their role in safeguarding vulnerable patients. They were fully aware they should go to the lead GP for safeguarding for further guidance. However some patients at risk of safeguarding had not been reviewed and monitored.

• The practice reviewed the needs of their local population and had initiated positive service improvements for patients. They implemented suggestions for improvements as a consequence of feedback from the patient participation group.

• There was evidence that innovation and service improvement was a priority among staff and leaders with evidence of strong team working and commitment to personal and professional development.

We saw several areas of outstanding practice :

• The practice had introduced ‘Patient Friends’ who were reception staff who were available throughout the day to review and discuss any problems from the patient’s perspective and use their knowledge of the practice to find a way of resolving issues quickly.

• The practice had taken part in the Routine Enquiry into Adverse Childhood experience (REACH) feasibility project which had been carried out to investigate long term physical and mental health problems in a primary care setting. As a result staff had been trained to identify and offer support where appropriate.

• The practice had developed a Well Pathway for patients with dementia covering prevention, diagnosis, living with and supporting people and dying well, with hypertext links to local and national support organisations.

• The practice was a member of the North West Alliance Primary Care Home which aimed to improve services in communities and offer patients opportunities to maximise their health. They worked together with partner organisations in the voluntary, social care and faith sectors.

There were areas where the provider must make improvements:

• Ensure care and treatment is provided in a safe way to patients

The areas where the provider should make improvements are:

• Improve engagement with patients experiencing poor mental health.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice