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Preston Grove Medical Centre - Yeovil Good

Reports


Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about Preston Grove Medical Centre - Yeovil on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Preston Grove Medical Centre - Yeovil, you can give feedback on this service.

Review carried out on 19 November 2019

During an annual regulatory review

We reviewed the information available to us about Preston Grove Medical Centre - Yeovil on 19 November 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 17 July 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Preston Grove Medical Centre on 3 November 2016. The overall rating for the practice was good. The practice was rated as good for providing effective, caring, responsive and well-led services and requires improvement for providing safe services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Preston Grove Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17July 2017 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 3 November 2016. 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. The practice is rated as good for providing safe services.

At our previous inspection on 3 November 2016, we rated the practice as requires improvement for providing safe services. This was because the arrangements in respect of infection prevention and control, management of medicines and the management of staff training were not adequate.

At this inspection on 17 July 2017 our key findings were as follows:

  • The practice had an induction programme for newly appointed staff which now included mandatory training in respect of infection prevention and control, safeguarding adults and the Mental Capacity Act (2015).

  • The staff training matrix evidenced that all staff had undertaken appropriate training to their role including; safeguarding adults training, infection prevention and control training and Mental Capacity Act training. We saw training records showed that staff who supported patients with long term conditions had received relevant refresher training including updates in asthma and diabetes.

  • There were arrangements in place to assess and monitor the risk, prevention, detection and control of the spread of infections.

  • Medicines, including the required arrangements for temperature control of vaccine storage, were managed appropriately.

  • The practice had made improvements in arrangements to support patients with diabetes.

  • Medicines including the required arrangements for temperature control of vaccine storage, were managed appropriately.

  • The practice had made improvements in arrangements to identify and support patients who were also carers.

  • Telephone access arrangements to the practice had improved for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 3 November 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Preston Grove Medical Centre on 3 November 2016. There are areas of safety which require improvement, however, overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • The practice participated in a local quality and outcomes framework, Somerset Practice Quality Scheme (SPQS), rather than the Quality and Outcomes Framework (QOF), to monitor practice performance and outcomes for patients.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • Although risks to patients were assessed, the systems to address these risks were not fully implemented in order to ensure patients were kept safe. For example, we found gaps in the arrangements for medicines management; infection prevention and control.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained in order to provide them with the skills, knowledge and experience to deliver care and treatment.
  • Generally records for the effective running and delivery of the service were in place, however, there were gaps in staff training records for example in respect of safeguarding and infection prevention and control.
  • Patients said they were treated with compassion, dignity and respect and told us they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. However, patient feedback from the GP Patient Survey indicated it was not always easy to get through to the practice by telephone to make appointments.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management.
  • The practice proactively sought feedback from staff and patients, which it acted on. We saw evidence of an active and supportive patient group.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • We saw evidence of patient centred care for patients with diabetes provided via ‘virtual clinics’ involving a specialist diabetes nurse and hospital consultant.
  • We saw effective arrangements in place to provide acute clinical care to patients that included a team of two nurse practitioners supported by a duty doctor each day.
  • We saw innovative approaches to providing integrated patient-centred care. For example, a team of health coaches was in place, each working with designated GPs; and there was evidence of benefits to patients and a reduction in the level of demand for GP appointments.

The areas where the provider must make improvement are:

  • Ensure the proper and safe management of medicines, including the required arrangements for temperature control of vaccine storage.
  • Ensure arrangements are in place to assess the risk of prevention, detection and control of the spread of infections

  • Ensure effective record keeping in relation to persons employed, including records of staff training and development relevant to their duties; and the management of regulated activities.

The areas where the provider should make improvement are:

  • Review the arrangements for telephone access to ensure patients can contact the practice easily. For example, 58% of patients found it easy to get through to this practice by phone compared with the national average of 73%.
  • Review the arrangements to identify and support all patients who are carers.
  • Review the arrangements to improve outcomes for patients with diabetes. We saw evidence of patient centred care for these patients provided via ‘virtual clinics’, however, overall Quality and Outcomes Framework (QOF) achievement for patients with diabetes was 57%, which was 22% below the clinical commissioning group (CCG) average.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During a check to make sure that the improvements required had been made

We spoke with the practice manager about their action plan following out last inspection on 18 February 2014.

We had identified four areas of their recruitment process which had not been fully applied. The four areas of concern were;

� Ensuring people�s identity was checked during recruitment and records kept of the checks made;

� Gathering a full employment history with any gaps in employment being fully explained;

� Completing disclosure and barring service (DBS) checks for all staff who had access to vulnerable patients or their records; and

� Obtaining information about the conduct and character of staff being employed.

The practice manager told us they had reviewed the practices recruitment policies. They had made changes to their processes of recruiting new staff to ensure recruitment processes protected patients from potential abuse. The documents they provided us showed improvements since our previous inspection.

Inspection carried out on 18 February 2014

During a routine inspection

Patients� privacy and dignity were maintained. We spoke with five patients who told us they felt their privacy was respected at the medical centre. Patients told us that communication with both clinical and non-clinical staff at the medical centre was good. One patient said, �They are so friendly, helpful and understanding here.� Another person told us, �They are all so nice and helpful, it�s excellent here.�

Patients told us that appointments were easily made and sufficient time was allocated to discuss their health concerns with their GP or other healthcare professionals at the medical centre. One patient we spoke with told us, �If you need an urgent appointment you will get one.� Another patient when asked about appointments said, �I�ve always got one (an appointment) when I�ve needed one.�

The medical centre had effective arrangements to ensure cleanliness and we found that the medical centre was clean. One patient told us, �It�s (the cleanliness) very good. It�s excellent here.� Another patient said, �I�ve no issues about the cleanliness here.�

The provider did not operate effective recruitment procedures to ensure staff suitability for employment.

The provider regularly monitored the quality and safety of the service and made improvements when necessary.