The Care Quality Commission
  • Doctor
  • GP practice

Archived: The Dove Medical Practice

Overall: Good read more about inspection ratings

60 Dovedale Road, Birmingham, West Midlands, B23 5DD 0845 675 0559

Provided and run by:
The Dove Medical Practice

Important: The provider of this service changed. See new profile

All Inspections

23 June 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at The Dove Medical Practice on 23 June 2016.

During our previous inspection of the practice on 10 December 2015 the practice was rated requires improvement for safe and effective domains leading to an overall rating of requires improvement. The practice was issued with a requirement notice for breach in regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Fit and proper persons employed. This inspection was to review the action taken by the provider to meet both the regulatory requirements where we had previously identified a breach and to report on the action taken for any other issues within the safe and effective domains. For this reason we have only rated the location for the safe and effective domains. The report should therefore be read in conjunction with the full inspection report published in March 2016.

At this inspection we found the practice had made changes since their previous inspection in December 2015 and was now meeting the requirements of the breach identified at the previous inspection. We also found that sufficient action had been taken regarding other issues identified at the previous inspection. This meant that the practice was now rated good for both safe and effective domains leading to an overall rating of good.

Specifically we found that since the last inspection, the practice had:

  • A robust system in place for sharing, learning and analysing significant events.
  • The practice had implemented a new recruitment policy that ensured all necessary employment checks for staff such as evidence of satisfactory conduct in previous employment were being carried out. We saw evidence to demonstrate that the new processes were being followed.
  • Put in place a new telephone triage system to improve the processes for making non-urgent appointments. A patient survey had been carried out in conjunction with the patient participation group (PPG) to get patient feedback regarding the new system.
  • Reviewed policies and procedures to ensure they were practice specific and to enable better monitoring of processes.
  • Made targeted and focused efforts to improve patient outcomes in areas identified for improvement. The practice was previously identified as an outlier for QOF (or other national) clinical targets for diabetes, hypertension and emergency admissions. However, at this inspection we saw evidence to demonstrate significant improvements in these areas and in almost all cases the latest unpublished QOF data showed that the practice was now performing in line with local and national averages.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Dove Medical Practice on 10 December 2015. Overall the practice is rated as requires improvement.

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

  • Staff we spoke with understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Data showed patient outcomes were low for the locality in relation to diabetes, hypertension and emergency admissions. We saw audits had been carried out and there was evidence that these has resulted in some improvement in performance to improve patient outcomes.
  • Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Results from the national GP patient survey from 2 July 2015 showed that patient satisfaction scores in relation to access to appointments were lower than local and national averages. Patients we spoke with also told us they did not find it easy to make a routine appointment with a named GP although urgent appointments were available the same day.
  • The practice had a number of policies and procedures to govern activity, although some were not practice specific.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available.
  • There was a clear leadership structure in place and staff we spoke with were motivated and felt supported by management. The practice had sought feedback from patients and had an active patient participation group in place.

The areas where the provider must make improvements are:

  • Ensure recruitment arrangements include all necessary employment checks for all staff such as evidence of satisfactory conduct in previous employment.

In addition the provider should:

  • Improve the processes for sharing learning from significant events internally and implement a process to analyses any trends.
  • Review the practice can further improve the availability, processes and patient experiences of making non-urgent appointments.
  • Review and update procedures and guidance to ensure they are reflective of the requirements of the practice. For example practice-specific recruitment and health and safety policies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice