Bunbury Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bunbury medical Practice on 11 October 2016.

Overall the practice is rated as requires improvement.

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

• There were systems in place to reduce risks to patient safety, for example, infection control procedures and the management of staffing levels. Improvements were needed to ensure safety checks at the premises took place. We also identified improvements that should be made to improve the safety of the service.

• Staff understood their responsibilities to raise concerns and report incidents and near misses. Changes had been made to the management of significant events as a result of this inspection and these need to be reviewed to ensure they are effective.

• Staff spoken with knew how to identify and report safeguarding concerns. Improvements were needed to the system for recording safeguarding alerts as this process lacked consistency. The system for ensuring GPs provided reports for child safeguarding meetings needed to be reviewed as we identified a response had not been made to a request.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff told us they felt well supported. The records of staff training did not demonstrate that all staff had received the training they required for their roles.

• Patients were positive about the care and treatment they received from the practice. The National Patient Survey July 2016 showed that patients’ responses about whether they were treated with respect, compassion and involved in decisions about their care and treatment were comparable to local and national averages.

• Services were planned and delivered to take into account the needs of different patient groups.

• The National GP Patient Survey results showed that patient’s satisfaction with access to care and treatment was above or in line with local and national averages.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

However there were areas of practice where the provider must make improvements:

• The provider must ensure the premises are safely maintained.

• The provider must improve their governance systems to ensure that clear records are maintained of the training staff have undertaken and effective systems are in place for the management of significant events and ensuring reports are provided for child safeguarding meetings.

The areas where the provider should make improvements are:

• The system for ensuring alerts are placed on computer records to indicate any concerns about patients’ welfare should be improved.

• Maintain a complete record of which clinician pre-printed prescriptions have been allocated to.

• A system should be put in place to identify the medication to be held in GPs bags and to record that it has been checked and is available and in date.

• The induction records should be more comprehensive to reflect the detail of the information provided.
• A documented risk assessment should be put in place to demonstrate why a Disclosure and Barring (DBS) check is not required for staff who act as chaperones.
• Staff recruitment records should contain two references and evidence of information having been gathered about any physical or mental conditions which were relevant (after reasonable adjustments) to the role the person was being employed to undertake.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice