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North Harbour Medical Group Good

Inspection Summary


Overall summary & rating

Good

Updated 13 December 2016

Letter from the Chief Inspector of General Practice

We carried out a focused follow up inspection of North Harbour Medical Group on 8 November 2016. This inspection was performed to check on the progress of actions taken following an inspection we made on 1 March 2016. These included;

  • A lack of governance arrangements in the practice for the administration of vaccines under patient group directions (PGD) to ensure staff were competently trained and that the PGD was completed in a timely manner to ensure nurses did not practice outside of the legal framework.
  • A lack of systems to ensure the practice was able to respond to medical emergencies. Specifically, improving the processes for managing emergency medicines, defibrillator, oxygen cylinders and labelling of the anaphylaxis medicines kit to minimise risks.
  • A need to improve governance arrangements for prescription tracking and monitoring.
  • The provider should raise awareness of the number of carers on the practice carer’s register.

Following the inspection in March 2016 the provider sent us an action plan which detailed the steps they would take to meet their breaches of regulation. During our latest inspection on 8 November 2016 we found the provider had made the necessary improvements in delivering safe, well led services.

This report covers our findings in relation to the requirements and should be read in conjunction with the comprehensive inspection report published in May 2016. This can be done by selecting the 'all reports' link for North Harbour Medical Group on our website at www.cqc.org.uk

Our key findings across the areas we inspected in this focused follow up inspection were as follows:

  • There were now well organised governance arrangements in place for the administration of vaccines under patient group directions (PGD) to ensure staff were competently trained and that the PGDs had been completed in a timely manner.
  • Systems were now in place to ensure the practice was able to respond to medical emergencies.
  • Improved governance arrangements for prescription tracking and monitoring were in place in line with guidance from NHS Protect.
  • The provider had raised awareness of the number of carers on the practice carer’s register and their numbers had increased accordingly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 13 December 2016

At our inspection in March 2016 we found that the provider needed to make improvements. For example;

  • The system for managing vaccines did not ensure that staff were competent to give vaccines within the Patient Group Direction (PGD). Additionally, the system for managing medical emergencies failed to identify expired defibrillator pads and expired emergency medicines.

  • A lack of systems to ensure the practice was able to respond to medical emergencies.

Significant improvements had been made since the previous inspection. The practice is now rated as good for providing safe services. For example;

  • There were now well organised governance arrangements in place for the administration of vaccines under patient group directions (PGD) to ensure staff are competently trained and that the PGDs had been completed in a timely manner.

  • Systems were now in place to ensure the practice was able to respond to medical emergencies.

Effective

Good

Updated 13 December 2016

Caring

Good

Updated 13 December 2016

Responsive

Good

Updated 13 December 2016

Well-led

Good

Updated 13 December 2016

At our inspection in March 2016 we found that the provider needed to make improvements. For example;

  • Staff were not always clear about the vision and values and not completely aware of their responsibilities in relation to these.

  • There was a limited overarching governance framework which affected the delivery of the strategy and good quality care. This included arrangements to monitor emergency equipment and medicines.
  • The provider should raise awareness of the number of carers on the practice carer’s register.

Significant improvements had been made since the previous inspection. The practice is rated as good for being well-led. For example;

  • The practice had discussed the importance of their vision and values at team meetings, and during staff one to ones. Staff we spoke with were aware of the vision and values and their responsibilities with regard to these.
  • The practice had fully updated their overarching governance framework.
  • The provider had raised awareness of the number of carers on the practice carer’s register and their numbers had increased accordingly.
Checks on specific services

People with long term conditions

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.

Families, children and young people

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.

Older people

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.

Working age people (including those recently retired and students)

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.

People experiencing poor mental health (including people with dementia)

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.

People whose circumstances may make them vulnerable

Good

Updated 13 December 2016

We did not inspect the population groups as part of this inspection. However, the outcomes we found when inspecting the Safe and Well-led domains mean the rating for this population group is now Good.