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Archived: Donald Wilde Medical Centre Good

Reports


Review carried out on 15 November 2019

During an annual regulatory review

We reviewed the information available to us about Donald Wilde Medical Centre on 15 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 18/05/2018

During a routine inspection

This practice is rated as Good overall. (Previous inspection September 2017 – Requires improvement).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

The practice was inspected on 29 September 2017 and was rated requires improvement. Requirement notices were issued in relation to regulatory breaches of Regulation 16 (Receiving and acting on complaints), Regulation 17 (Good governance) and Regulation 19 (Fit and proper persons employed). This report can be viewed by selecting the ‘all reports’ link for Donald Wilde Medical Centre on our website at www.cqc.org.uk.

This announced comprehensive inspection at Donald Wilde Medical Centre was carried out on 18 May 2018. This was a full inspection that also looked in detail at these areas where improvement was required following the September 2017 inspection.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 29/09/2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We first carried out an announced comprehensive inspection of Donald Wilde Medical Centre on 10 March 2015. The practice was then rated as good in all areas.

We carried out an unannounced focussed inspection at Donald Wilde Medical Centre on 3 August 2016 in response to receiving allegations from a whistleblower. During the August 2016 inspection we found breaches in regulations 16 (receiving and acting on complaints), 17 (good governance) and 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The full reports for the March 2015 and August 2016 inspections can be found by selecting the ‘all reports’ link for Donald Wilde Medical Centre on our website at www.cqc.org.uk.

This inspection, on 29 September 2017, was an announced comprehensive inspection, where we also checked that previously identified breaches had been acted on. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, significant events were not fully reviewed and evidence of learning was not kept.
  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
  • Data showed patient outcomes were usually at or above average when compared to the national average.
  • We saw one example of a completed audit cycle. However, audits were not used as a way of driving improvements and they were not shared with all clinicians.
  • The repeat prescribing of high risk medicines was not always effective, with protocols not providing enough information for clinicians.
  • Training was not well-monitored and there was no evidence of induction training.
  • The majority of patients said they were treated with compassion, dignity and respect.
  • Information about services was available, including some information translated into Bengali.
  • The practice had a number of policies and procedures to govern activity, but these were not always followed.

The areas where the provider must make improvements are:

  • Ensure all complaints are dealt with appropriately.

  • Establish effective systems and processes to ensure good governance is in place in accordance with the fundamental standards of care.

  • Undertake clinical audits in a way to drive improvement for patients.

  • Ensure procedures are in line with the practice policies, and review protocols to ensure they contain sufficient information.

  • Ensure learning from significant events is documented and monitored.

  • Review the system in place for the monitoring of training.

  • Ensure recruitment arrangements include all necessary employment checks for all staff.

In addition the provider should:

  • Consider having a nebuliser so certain medicine kept at the practice can be administered.

  • Work towards increasing the number of carers on the carers register, and improving provider support for carers.

  • Have a policy for patients under the age of 16 making appointments and ensure reception staff are all aware of the correct procedure.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 03/08/2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

On 19 July 2016 we received allegations about Donald Wilde Medical Centre from an anonymous whistleblower. Not all of the allegations related to aspects of the Health and Social Care Act (Regulated Activities) Regulations 2014. The allegations relating to the Act were:

  • There were no GP surgeries taking place some afternoons.

  • There had been an increase in patient complaints due to the lack of surgeries available.

  • Staff were being employed without the appropriate recruitment checks being carried out.

In response to the allegations being received we carried out an unannounced focussed inspection, just looking at the allegations we received.

We found that:

  • In the week prior to the inspection GP surgeries had been held every morning and afternoon, Monday to Friday. The number of appointments provided was in line with recommended guidelines.

  • Verbal complaints had been made about access to appointments but these had not been recorded. Previous complaints made to the practice had not been responded to appropriately. For example, written responses did not inform complainants of how they could escalate their complaint to the Parliamentary and Health Service Ombudsman (PHSO).

  • No personnel information was held for some staff such as the practice nurse, advanced nurse practitioner, locum GPs and the two most recently recruited administrative staff.

The areas where the provider must made improvements are:

  • The provider must ensure that all complaints received are investigated and responded to, with escalation procedures brought to the attention of complainants.

  • The provider must ensure all policies and protocols are up to date so they can be assured all clinicians and staff follow the same procedure.

  • The provider must ensure all appropriate employment checks are carried out prior to employing staff. They must ensure all clinicians have up to date registration with the appropriate professional body.

The practice was previously inspected on 10 March 2015. The practice was rated ‘good’ across all domains and ‘good’ overall. The ratings will not change following this inspection, although the provider will be expected to make the required improvements. However, the practice will receive a full comprehensive inspection in the future and ratings in all domains will be considered.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 10 March 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Donald Wilde Medical Centre on 10 March 2015. We found that the practice was rated as good overall.

Our key findings were as follows:

  • The practice is rated as good for safe. Staff understood their responsibilities to raise concerns, and report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. There were enough staff to keep people safe.

  • The practice is rated as good for effective. National Institute for Health and Care Excellence (NICE) guidance was referenced and used routinely. Patient’s needs were assessed and care was planned and delivered in line with current legislation. This included the promotion of good health. Staff had received training appropriate to their roles and further training needs were identified and planned. The practice had an effective appraisal system in place for all staff. Multidisciplinary working was evidenced.

  • The practice is rated as good for caring. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them. We also saw that staff treated patients with kindness and respect ensuring confidentiality was maintained.

  • The practice is rated as good for responsive. The practice reviewed the needs of their local population and engaged with the NHS Local Area Team (LAT) and Clinical Commissioning Group (CCG) to secure service improvements where these were identified. Patients reported good access to the practice and the GPs and continuity of care, with urgent appointments available the same day. The practice had good facilities and was well equipped to treat patients and meet their needs. There was an accessible complaints system with evidence demonstrating that the practice responded quickly to issues raised.

  • The practice is rated as good for well-led. The practice had a clear vision and strategy to deliver this. There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity. There were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients and this had been acted upon. Staff had received inductions, regular appraisals and attended staff meetings. The practice had a developing patient participation group (PPG).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice