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Inspection carried out on 17/12/2018

During a routine inspection

We carried out an announced comprehensive inspection at Ifield Medical Practice on 17 December 2018 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as good overall. We rated it as good for its treatment of all the population groups.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Inspection carried out on 16 December 2015

During an inspection to make sure that the improvements required had been made

The practice was rated as Requires Improvement overall and is now rated as Good for providing safe services, Good for providing effective services and Good for providing services that are well-led.

We carried out an announced comprehensive inspection of this practice on 11 March 2015 and improvements were required in the safe, effective and well-led domains. The practice sent us an action plan detailing what they would do to make improvements..

We conducted a focused inspection on 16 December 2015 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements..

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During this inspection we found:-

  • All staff were now trained in safeguarding children and vulnerable adults at an appropriate level to their role.

  • All staff who undertook chaperone duties had now been appropriately trained for that role

  • All of the actions identified in the infection control audit referred to in the initial inspection had been effectively managed. A further audit had been conducted on 6 August 2015 and improvement noted. The findings were formally discussed at a clinical meeting.

  • A fire evacuation rehearsal had been conducted on 3 June 2015 and 8 December 2015. This had resulted in learning and improved efficiency in the process.

  • The practice had developed and implemented a Prescription Control Protocol. This had resulted in the auditing of stocks of printer prescriptions and prescription pads.The practice was able to evidence that meetings were being held with GPs, nurses and non-clinical managers every two months. The agenda for those meetings included complaints, significant events and clinical matters.

  • The practice had appointed a member of the management team as audit co-ordinator and had initiated a small programme of audits. The full cycles were yet to be completed.

  • All staff requiring a Disclosure and Barring Service (DBS) check were now in receipt of one, including those undertaking chaperone duties.

There were areas where the provider needed to continue to make improvements. The provider should:

  • Review the format of the fire evacuation roll-call sheet to prevent any errors in accounting for staff.

  • Proactively drive the programme of audits forward and include definitive timescales for two audit cycles for each subject area to be completed.

  • Ensure that the practice reminds relevant personnel of the Prescription Control Protocol security recommendations for prescriptions taken out of the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 11 March 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Ifield Medical Practice on 11 March 2015. We visited the practice location at Lady Margaret Road, Ifield, Crawley, West Sussex RH11 0BF.

Overall the practice is rated as requires improvement. Specifically, we found the practice to be good for providing caring and responsive services. It requires improvement for providing safe, effective and well led services. It also requires improvement for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

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

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • The practice understood the needs of the local population and planned services to meet those needs.
  • The practice worked closely with external agencies and community services to meet the needs of patients and ensure continuity of care.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Staff had not always received training appropriate to their roles. Some staff had not received training in the safeguarding of children and vulnerable adults at a level appropriate to their role. Reception staff who acted as chaperones had not always received training to support this role.
  • Learning from recorded incidents and clinical audit findings were not always reviewed and followed up to promote continuous improvement.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Ensure that all staff are trained in safeguarding of children and vulnerable adults at a level appropriate to their role.
  • Ensure all staff acting as chaperones are appropriately trained for the role.
  • Ensure the actions identified as a result of auditing of infection control processes are documented and reviewed so that progress and completion can be monitored.
  • Ensure regular rehearsal of fire evacuation procedures within the practice in order to assess and monitor the risks associated with such an emergency.
  • Ensure effective arrangements are in place to ensure the safe storage of prescription pads at all times, particularly when the practice is closed.

In addition the provider should:

  • Establish a process to ensure more formal sharing of information and learning from incidents for all staff.
  • Ensure learning points from incidents and audits are followed up and reviewed.
  • Develop a programme of clinical audit and ensure audit cycles are completed to promote continuous improvement to patient care.
  • Provide regular opportunities for nurses and GPs to meet to reflect on clinical practice and best practice guidance.
  • Ensure that all staff who require a DBS checks have received one, including those staff undertaking chaperone duties.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice