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Inspection carried out on 25/09/2019

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection at The Arthington Medical Centre on 17 October 2018. The overall rating for the practice was good. However, we rated the practice as requires improvement for providing caring services. The full comprehensive report for that inspection can be found on the Care Quality Commission website, by selecting the ‘all reports’ link for The Arthington Medical Centre.

This inspection was an announced focused inspection carried out on 25 September 2019, to confirm the practice had made the required improvements in providing caring services. At this inspection we also reviewed the several aspects of care where we told the provider they should improve.

Our key findings were as follows:

  • On the day of inspection patient feedback was positive regarding the care and support offered by the practice. Patients told us they were treated with dignity and respect and they were listened to. The provider had reviewed the outcomes of the 2019 National GP Patient Survey and we saw that three out of the five indicators we reviewed had improved since the 2018 survey. Whilst responses to this survey remained below CCG and national averages, responses to the practice’s own survey undertaken between July and September 2019 were more positive and the response rate was higher, representing 3% of the patient population. The practice had made a number of changes since their last inspection which aimed to improve the patient experience.

In addition:

  • The provider had reviewed and improved the range of vaccinations and immunisations offered to staff, in line with guidelines. There was evidence to support that the immunisation status of staff was recorded and that staff had been appropriately immunised. Occupational health support was also available for all staff.
  • The provider had reviewed how communication with staff could be improved to support staff raising concerns. We saw evidence of discussions at staff meetings and staff told us they were happy in their roles. We were told the new practice management team were communicative, supportive and approachable. One to one appraisals were planned. Staff were aware of the whistleblowing policy and of where they could access support. A 2019 staff survey confirmed that recent changes had resulted in increased job satisfaction and had contributed to an open and honest culture within the team.
  • The provider had significantly improved the identification of patients who acted in the capacity of a carer. A carers’ champion worked with the team to proactively support this vulnerable group of patients.

Whilst we found no breaches of regulations, the provider should:

  • Monitor and continue to work towards improving patient satisfaction at the practice.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.

Inspection carried out on 17 October 2018

During a routine inspection

We carried out an announced comprehensive inspection at The Arthington Medical Centre on 17 October 2018, as part of our inspection programme.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from the provider, patients, public, other organisations and our ongoing monitoring of data about services.

We have rated this practice as good overall.

We concluded that:

  • Patients were protected from avoidable harm and abuse and that legal requirements were met.
  • Patient care and treatment was delivered in line with current best practice guidance.
  • The leadership, governance and culture of the practice promoted the delivery of quality person-centred care.

However, we also found that:

  • Some staff informed us that communication systems within the practice did not always meet their needs. They told us they did not always feel they were supported to raise concerns.
  • It was noted that records were not available for all staff to assure the practice of their occupational health immunisation status.
  • Less than 2% of registered patients had been identified as a carer.

We rated the practice as requires improvement for providing caring services because:

  • Patients’ satisfaction with how cared for they felt was consistently, and in some cases significantly, below local and national averages. This included a significant proportion of patients surveyed who claimed the healthcare professional they last had an appointment with was good or very good at treating them with care and concern.
  • The provider informed us they were striving hard to improve patient satisfaction overall. However, the impact of this work had not been formally assessed at the time of inspection.

Whilst we found no breaches of regulations, the provider should: