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Archived: Heald Green Health Centre 2 Good Also known as Dr Wright & Partners

Reports


Inspection carried out on 9 June 2017

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Heald Green Health Centre 2 on 30 November 2016. At the inspection in November the overall rating for the practice was good, although the key question Safe was rated requires improvement. This was specifically in relation to the management of medicines that required patients to receive regular health care checks and the systems to ensure medicines were changed and checked appropriately when requested by a secondary care provider such as a hospital consultant. We also identified some areas where the practice could improve other aspects of the service they provided. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Heald Green Health Centre 2 on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 30 November 2016. This report covers our findings in relation to those requirements and also the additional improvements made by the practice since our last inspection.

The practice is now rated as good for providing safe services, and overall the practice is rated as good.

Our key findings were as follows:

  • Since the previous inspection the practice had employed a pharmacist to assist the GPs with the management of medicines. This included identifying and monitoring those patients who required regular health checks and those patients discharged from hospital with changes to their prescribed medicines.
  • A protocol had been established so that prescriptions for repeat requests for medicines such as for example Warfarin (blood thinning medicine) were only issued if an up to date blood result (INR)was available.
  • The systems to ensure the practice received Warfarin blood results in a timely manner had been reviewed and improved communication links had been established with a local hospital that carried out the INR blood testing.
  • Patients prescribed other high risk medicines such as disease-modifying anti-rheumatic drugs (DMARDs) were monitored with monthly searches on patient records to ensure the appropriate checks such as blood tests had been undertaken. In addition a screen message had been added to each patient’s electronic record so that staff could easily identify those patients requiring these checks.
  • The practice management team had reviewed their procedure in relation to monitoring and responding to pathology tests results. The practice ensured that all pathology test results were allocated out to those GPs on duty each day. This ensured that these were checked within the appropriate timescale.
  • The practice had made improvements to the practice’s record systems. For example a safety alert log was now established and accessible to staff. This provided a brief record of actions taken and hyperlinks to the relevant documents.
  • The practice also maintained a log of significant events with a brief description of the incident and log of action taken all staff. A log of all meetings was also maintained.
  • The practice had undergone some staff changes since the last inspection and this had enabled the practice to review its staffing establishment and the activities undertaken by the different staff teams. This had resulted in a streamlining of the nursing team and appointments scheduling and a change in how GP appointments were scheduled.
  • As part of the local Clinical Commissioning Group (CCG) initiative the practice has had a new telephone system installed however the additional benefits from the system had yet to be ‘switched’ on by the CCG.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 30/11/2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Heald Green Health Centre 2 on 30 November 2016. Overall the practice is rated as good. 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. Significant events had been investigated and action had been taken as a result of the learning from events for the sample we looked at. However, the provider’s system for recording significant events was difficult to navigate. This in turn could make an overview of events difficult to maintain.

  • Systems were in place to deal with medical emergencies and all staff were trained in basic life support.

  • There were systems in place to reduce risks to patient safety. However, some of these required review. For example, the system in place for managing safety alerts required review as there was no overview to demonstrate/ensure that all alerts had been acted on appropriately. Some medicines management procedures required improvement. These included; checks for people taking high risk medicines and prescribing practices.

  • Infection control practices were carried out appropriately and there were regular checks on the environment and on equipment used.

  • Feedback from patients about the care and treatment they received from clinicians was very positive.

  • Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.

  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.

  • Patients said they found it easy to make an appointment and there was good continuity of care.

  • The appointments system provided a range of appointments to meet patients’ needs including urgent and on the day appointments. Feedback from some patients was that they had difficulty getting through to the practice by phone and that they sometimes waited too long for a routine appointment

  • The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

  • Complaints had been investigated and responded to in a timely manner.

  • There was a clear leadership and staff structure. Staff understood their roles and responsibilities. However, some staff told us their roles were more challenging as a result of working across two practices.

  • The practice provided a range of enhanced services to meet the needs of the local population.

  • The practice sought patient views about improvements that could be made to the service. This included the practice having and regularly consulting with a patient participation group (PPG).

Areas where the provider must make improvement:

  • Ensure all patients who are taking high risk medicines have regular health and medication checks in line with best practice guidance.

  • Ensure prescribing practices for managing changes in medicines are carried out appropriately and safely.

Areas where the provider should make improvement:

  • Review the procedures for the management of results from secondary care with particular attention to short term clinical staff.

  • Review the system for recording significant events to ensure the records are fully accessible and allow for a clear overview of events and actions taken.

  • Review the system for managing safety alerts to ensure an overview of actions taken.

  • Review the appointments system for managing routine appointment requests.

  • Review the effectiveness of the telephone/call management system following completion of the installation.

  • Continue to monitor and review back office staffing arrangements in relation to the role of staff working across two practices.

  • Maintain a clearly detailed record of meetings and actions agreed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice