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Review carried out on 5 July 2019

During an annual regulatory review

We reviewed the information available to us about Firsway Health Centre on 5 July 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 19/04/2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

On 16 January 2015 we carried out a full comprehensive inspection at Firsway Health Centre. The inspection was rated as requires improvement.

Improvements were specifically required in the following areas:

  • Regulation 10 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Assessing and monitoring the quality of service provision.

  • Regulation 11 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Safeguarding people who use services from abuse.

  • Regulation 12 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Cleanliness and infection control.

  • Regulation 13 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Management of medicines.

  • Regulation 21 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Requirements relating to workers.

  • Regulation 23 of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2010, Supporting staff.

The Health and Social Care Act 2008 (Regulated Activity) regulations 2014 replaced the above regulations in April 2015.

This inspection took place on 19 April 2016 and was a focussed inspection to check improvements had been made. We inspected areas of each domain. We found all the required improvements had been made and the practice is now rated as good.

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.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • 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. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a GP and 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.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

  • The practice had a system in place to monitor and review families at risk with health visitors. These meetings took place fortnightly. There was a code on the practice’s computer system so that all clinicians were aware of there was an issue with a family.

  • The practice had developed templates for use when prescriping certain medicines, for example oral contraception. Up to date NICE guidance was inbuilt into these templates as a prompt for GPs, all relevant facts could be considered.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 16 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Firsway Health Centre on 16 January 2015. Overall the practice is rated as requires improvement.

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

  • Information from safety alerts and significant events were discussed at clinical meetings. However, some staff were not aware of the reporting procedure and identified learning needs were not always actioned.
  • Data showed patient outcomes were in line with the clinical commissioning group (CCG) average.
  • 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.
  • Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for non-urgent appointments.
  • The practice had a number of policies and procedures to govern activity, but some were outdated and some did not contain enough information to guide staff.
  • The practice had a set of values and a strategy in place for improvements. Due to circumstances beyond their control they had been unable to implement the strategy.

The areas where the provider must make improvements are:

  • The provider must ensure there are processes in place to seek the views of patients to enable an informed view in relation to the standard of care provided. Where it has been identified that improvements to the service are required, for example additional training needs to be arranged following a significant event, these should be monitored and put in place in a timely manner.
  • The provider must ensure they take reasonable steps to identify the possibility of abuse and prevent it before it occurs.
  • The provider must ensure systems are in place to assess the risk of and prevent, detect and control the spread of health care associated infections.
  • The provider must ensure people are protected against the risks associated with the unsafe use and management of medicines by having arrangements in place for the safekeeping of medicines at the correct temperature.
  • The provider must ensure they operate an effective recruitment system by obtaining the information required under Schedule 3 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 and ensuring staff are of good character.
  • The provider must ensure staff are appropriately supported in relation to their responsibilities by providing appropriate training, professional development, supervision and appraisal. Healthcare professionals must be enabled to provide evidence to their relevant professional body that they continue to meet the professional standards required as a condition of their registration.

In addition the provider should:

  • The provider should take action to ensure the working hours of all staff reflect the needs of patients.
  • The provider should ensure there are procedures in place for dealing with emergencies which are reasonably expected to arise from time to time.
  • The provider should improve the ways patients can communicate with the practice. For example, patients found it very difficult to get through to the practice on the telephone and it was not possible to book appointments on-line.
  • The provider should ensure all staff knew the procedure to follow if a patient made a complaint.
  • The provider should ensure a protocol is in place regarding what action to take if patients do not attend an appointment for a health check or review.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice