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Dr Webb and Partners Requires improvement

Reports


Inspection carried out on 13 January 2020

During a routine inspection

We rated the practice as requires improvement for providing well-led services because:

  • Site management responsibilities indicated a lack of ownership for site-related matters following assessment – for example, oversight of action plans relating to fire, Legionella and health and safety.
  • The oversight of some practice systems was not always sufficiently robust. This included the response to the findings of clinical audits, and the use of risk assessment processes to minimise and control identified risk areas.
  • Annual appraisals were overdue for non-clinical staff at the time of our inspection.
  • In addition, we found that leaders were not always receptive to the requirements needed to provide assurance as part of their registration with the CQC.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way (Please see the specific details on action required at the end of this report).
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the specific details on action required at the end of this report).

In addition, the provider should:

  • Ensure staff training records are kept updated and accessible.
  • Store unused vaccines in their original packaging when returned to the practice vaccine refrigerator.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 11 February 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Webb and Partners on 11 February 2019 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 requires improvement overall and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

  • The practice did not have effective systems in place for the safe management of health and safety including an active process to identify and control areas of risk.
  • Evidence of safe staff recruitment procedures required strengthening. Annual checks of professional registrations should be undertaken and documented.
  • The outcomes of safety alerts required clear evidence of the follow-up actions taken to keep patients safe.

We rated the practice as requires improvement for providing well-led services because:

  • The practice’s governance arrangements required improvement to ensure that there was clarity in terms of responsibilities for site management, with the provider maintaining evidence to demonstrate their ongoing compliance with regulations.

The overall rating for this practice was requires improvement due to concerns in providing safe and well-led services. However, the population groups were rated as good.

We rated the practice as good for providing effective, caring and responsive services because:

  • Patients received effective care and treatment that met their needs. The practice could demonstrate good patient outcomes were delivered, for example, by their achievement in the Quality and Outcomes Framework.
  • Staff treated patients with kindness and respect and involved them in decisions about their care. The practice ethos was to provide an accessible and approachable patient-orientated service.
  • Patients could access care and treatment in a timely way. The practice organised and delivered services to meet their patients’ needs.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way (Please see the specific details on action required at the end of this report).
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the specific details on action required at the end of this report).

In addition, the provider should:

  • Review the need to record dates when medicines checks are undertaken to review stock levels and expiry dates. Ensure that all prescription stationery is maintained securely.
  • Implement the staff induction checklist for new starters.
  • Continue to collate the evidence of staff immunisations in line with Public Health England guidance.
  • Ensure staff training records are updated including any evidence to support attendance at external training events.

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 28 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Webb and Partners on 28 January 2015. Overall the practice is rated as good.

Specifically, the practice was rated as good for providing safe, effective, responsive and caring services. In addition, it was rated as good for providing services to the six population groups.

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

  • Patients expressed high levels of satisfaction with the care and service they received. They said that they were treated with kindness, dignity and respect and were involved in decisions about their care and treatment.
  • The practice was accessible and well equipped to meet patients’ needs.
  • Patients were able to access care and treatment when they needed it. They described their experience of making an appointment as good, with urgent appointments usually available the same day.
  • Procedures were in place to help keep patients safe and to protect them from harm, although recruitment procedures required strengthening.
  • Patients felt listened to and able to raise concerns about the practice. Concerns were acted on to improve the service.
  • Staff felt valued, well supported, and involved in decisions about the practice. They were supported to maintain and develop their skills and knowledge to enable them to carry out their work effectively.
  • The practice had undergone various changes in the last six months since two partners had retired and a new GP had been appointed. Staff told us that the changes were well managed.
  • The staff team were committed to new ways of working to ensure the service was well-led. Systems were in place to assess and monitor the quality of services and to drive improvements.
  • The practice obtained and acted on patients views. The Patient Participation Group (PPG) worked in partnership with the practice to improve the services for patients.

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

Importantly the provider should

  • Strengthen the recruitment procedures to ensure the required employment checks are obtained for all staff. Also, develop the induction programme to take account of specific roles to enable new staff to carry out their work.
  • Ensure the clinical audit programme includes more completed audits, to demonstrate the changes made to patients care and treatment.
  • Ensure that all patients on the palliative care register are regularly discussed with relevant professionals, to aid communication and ensure they receive coordinated care.

  • Ensure that information available to patients enables them to understand the complaints process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice