Walton Village R Also known as Walton Village Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Walton R on 25 April 2016. Overall the practice is rated as requires improvement.

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

• The practice was a small family practice which had been at the heart of the community for many years and patients received a continuity of care from GPs. The practice nurse had retired and the practice had struggled to recruit a new nurse for over 12 months and had relied on local community nursing teams. A new practice nurse had joined the practice on the day of our inspection.

• The practice premises were in need of refurbishment, but plans for this were on hold as the practice was in the process of exploring options to move to new premises. The practice had limited disabled access and no hearing loop. There was access to translation services.

• The practice did not follow some health and safety legislation to ensure the safety of both patients and staff. Some risk assessments for health and safety had been carried out, but some actions had not been undertaken for the risks identified such as electrical and fire safety.

• The practice had recently employed a cleaning company but no monitoring systems or risk assessments were in place to ensure the practice was following national guidance for cleaning of premises. No infection control audits had been completed since 2013. The audits had demonstrated some improvements but standards were below those expected by the local infection control team.

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding. However, there were very few documented meetings and there was no clear audit trail as to how shared learning took place.

• Patients’ needs were assessed and care was planned and delivered in line with current legislation.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patient survey data and staff we spoke with demonstrated there were problems with waiting times for patients. The practice had identified this problem and had put some measures in place to tackle this issue, but had not yet evaluated whether this was enough to reduce waiting times.

• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service; including having a new patient participation group (PPG) and acted, where possible, on feedback.

• Staff worked well together as a team.

Importantly, the provider must:

Improve their knowledge and have due regard to all Health and Safety legislation and Health and Social Care Act 2008 (regulated activities) regulations:

• Carry out any actions identified in health and safety risk assessments for example, in fire risk assessments.

• Carry out electrical safety checks for the building.

• Carry out work station/display screen equipment risk assessments for all staff.

• Cary out risk assessments for infection control and cleaning of the premises and equipment to ensure the practice is meeting standards and following the code of practice for infection control and related national guidance.

• Improve governance systems in terms of risk assessments, audits, staff support and communications.

The provider should:

• Carry out risk assessments to specify how the practice would deal with emergency situations without having a defibrillator available.

• Have a stock monitoring system in place for blank prescriptions.

• Refurbish the practice if not moving premises.

• Improve waiting times for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice