Deddington Health Centre Also known as Dr Ruddock & Partners

Letter from the Chief Inspector of General Practice

We carried out a desktop review of Deddington Health Centre in September 2016. We requested information from the practice to be sent to us so we could undertake a review of evidence offsite. This was following a comprehensive inspection in January 2016 where we identified concerns with the monitoring of patient care and treatment and staff awareness of the Mental Capacity Act 2005. We issued a requirement notice and rated the practice as requires improvement in the effective domain. The practice sent us an action plan stating what they were going to do to make improvements. At this inspection we found:

• The monitoring of patient care and treatment had improved following an audit of diabetes related indicators as well as an audit of patients on Lithium (a high risk medicine).
• The process for medicine reviews had been changed to ensure patients received a review in a timely way.
• The nursing team had received training on the Mental Capacity Act 2005 and guidance had been introduced for mental capacity assessments.

During the previous inspection, we also reported on areas where improvements should have been considered. At this inspection we found that the practice had acted on these findings.

The practice had implemented a new alerts policy and vulnerable patients already registered were clearly flagged up on the records system. Overdue appraisals had also been brought up to date.

This report only covers our findings in relation to these requirements. You can read the report from out last comprehensive inspection by selecting the ‘all reports’ link for Deddington Health Centre on our website www.cqc.org.uk 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Deddington Health Centre on 27 January 2015. Overall the practice is rated as good. It requires improvement for providing effective services.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed, although the monitoring of high risk medicines was not adequate.
• Medicines were managed safely, including controlled drugs.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There was not a fully effective system for monitoring patient care and treatment. Some national data indicators suggested improvements were needed in patient care but the practice was not appropriately monitoring whether these improvements were being made.
• 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.
• Patients said they found it easy to make an appointment with a GP and that there was 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 a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• Governance arrangements were in place for non-clinical aspects of the service. However, clinical governance was not always adequate to ensure improvements were made to patient care when necessary.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice dispensed medicines to 98% of its population and the partners had identified delays for patients when collecting their medicines. In response the partners invested in a robotic (automatic) dispensing system to provide a more efficient dispensing system. Staff told us this had reduced delays in collecting medicines and there had been a reduction in complaints regarding dispensing delays. We observed the dispensary throughout the day and saw patients received their medicines efficiently. There was also a secure self-service prescription collection point which enabled out of hours pick up for most medicines. Patients could request to use this service which enabled them to pick up medicines any time on any day of the week.

The areas where the provider must make improvement are:

• Improve monitoring of patient care and treatment to include assurances that where improvements are required they are made. Specifically in monitoring of patients on repeat prescriptions, high risk medicines and diabetic care.
• Ensure the Mental Capacity Act 2005 is followed in the delivery of care to patients through full guidance and providing appropriate awareness to all clinical staff.

The areas where the provider should make improvement are:

• The flag for vulnerable patients should be clearly coded on the records system to alert staff.
• Bring overdue appraisals upto date to ensure staff development needs are reviewed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice