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Ashfield Medical Centre Good

Reports


Inspection carried out on 5 November 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Ashfield Medical Centre also known as Dr Cassidy & Partners, on 22 January 2019. The overall rating for the practice was good with the practice rated as requires improvement for being safe.

From the inspection on 22 January 2019, the practice was told they must:

  • Ensure care and treatment is provided in a safe way to patients.

In addition, the practice was told they should:

  • Continue with efforts to identify and support carers within the practice population.
  • Continue with efforts to improve patient satisfaction with particular regard to the areas highlighted in the results of the national GP patient survey as being in need of improvement.
  • Monitor staff training to ensure timely completion of mandatory training.
  • Complete proposed testing for staff to provide assurance on staff immunity status.
  • Continue with efforts to reduce prescribing of antibacterial and hypnotic medicines where appropriate.

The full comprehensive report on the inspection carried out in January 2019 can be found by selecting the ‘all reports’ link for Ashfield Medical Centre on our website at .

This inspection was an announced focused inspection at Ashfield Medical Centre undertaken on 5 November 2019 as part of our inspection programme to follow up on concerns identified at our previous inspection.

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 and good for all population groups.

We found that:

  • When incidents happened, the practice learned from them and improved their processes. In particular, improvements had been made to the management of safety alerts following concerns identified during our previous inspection.
  • The practice was working to support and identify carers within the population. There were 120 registered carers at the time of our inspection. The practice was using the support of the Integrated Community Support Team (ICST) to identify and support carers. The ICST provided the practice with access to a social work assistant who was able to offer additional support and information to carers and their dependents.
  • Systems for monitoring staff training had been developed. However, there was evidence of some gaps in record keeping. Immediately following our inspection, the practice submitted evidence to demonstrate these gaps were being filled.
  • The practice was making continued efforts to improve patient satisfaction as highlighted in the national GP patient survey. There had been some improvement in the practice’s performance in the most recent patient survey. For example, at the time of our previous inspection 28% of patients were satisfied with access to the practice via the telephone. This had improved to 45% in the most recent survey data (01/01/2019 to 31/03/2019). Similarly, satisfaction with the overall patient experience had improved from 65.6% to 74%.
  • All staff had been subject to appropriate testing of their immunity status in line with Public Health England Guidance. Those requiring additional vaccinations had received them.
  • The practice was able to demonstrate reduction in prescribing of antibacterial and hypnotic medicines where appropriate and was continuing with efforts to improve further.
  • The practice team displayed a willingness to learn and improve.

The areas where the provider should make improvements are:

  • Ensure all staff training records are appropriately maintained, particularly those relating to mandatory training as specified by the practice.
  • Continue with efforts to reduce prescribing of antibacterial and hypnotic medicines where appropriate.
  • Continue with efforts to improve patient satisfaction with particular regard to the areas highlighted in the results of the national GP patient survey as being in need of improvement.

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 22 January 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Cassidy & Partners also known as Ashfield Medical Centre, on 16 May 2018. The overall rating for the practice was good with the practice rated as requires improvement for being effective and well-led.

From the inspection on 16 May 2018, the practice was told they must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition, the practice was told they should:

  • Undertake regular review and analysis of significant events and complaints to identify and trends and areas of risk or improvement.
  • Undertake regular fire drills.
  • Encourage eligible patients to undertake NHS health checks for those aged 40 to 74 years.
  • Continue with efforts to improve uptake of national cancer screening programmes.
  • Continue to identify and support carers in their population.
  • Continue with efforts to improve patient satisfaction and performance in the national GP patient survey; with particular regard for patient experience during GP consultations and with the telephone system.
  • Establish a structured meeting system for the practice team in line with staff feedback.

The full comprehensive report on the inspection carried out in May 2018 can be found by selecting the ‘all reports’ link for Dr Cassidy & Partners on our website at.

This inspection was an announced comprehensive inspection at Dr Cassidy and Partners undertaken on 22 January 2019 as part of our inspection programme to follow up on concerns identified at our previous inspection.

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 and good for all population groups.

The practice is rated as requires improvement for providing safe services because:

  • Not all safety systems were well governed and operating effectively. For example, those related to the management of safety alerts needed strengthening.

We found that:

  • When incidents happened, the practice learned from them and improved their processes.
  • Patients received effective care and treatment that met their needs.
  • Systems for monitoring staff competencies and registrations had been developed.
  • 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.
  • Patients we spoke with were positive about improvements made to the appointment system. However, patient’s satisfaction in the national GP patient survey with access to the practice through the telephone system was low.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
  • The practice team displayed a willingness to learn and improve.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients. (Please refer to the requirement notice section at the end of the report for more detail).

The areas where the provider should make improvements are:

  • Continue with efforts to identify and support carers within the practice population.
  • Continue with efforts to improve patient satisfaction with particular regard to the areas highlighted in the results of the national GP patient survey as being in need of improvement.
  • Monitor staff training to ensure timely completion of mandatory training.
  • Complete proposed testing for staff to provide assurance on staff immunity status.
  • Continue with efforts to reduce prescribing of antibacterial and hypnotic medicines where appropriate.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Inspection carried out on 16 May 2018

During a routine inspection

This practice is rated as Requires Improvement overall. (Previous inspection February 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Dr Cassidy & Partners on 16 May 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

  • When incidents happened, the practice learned from them and improved their processes.
  • Not all safety systems were well governed and operating effectively. For example those related to staff vaccinations and risk assessments needed improvements.
  • Most staff had the skills, knowledge and experience to carry out their roles although the practice could not demonstrate training records for all staff.
  • Clinical performance data was comparable to the national and local data.
  • There were systems to review the effectiveness of the care provided and there was evidence of actions taken to support good antimicrobial stewardship (which aims to improve the safety and quality of patient care by changing the way antimicrobials are prescribed; so it helps slow the emergence of resistance to antimicrobials thus ensuring antimicrobials remain an effective treatment for infection).
  • Systems for monitoring staff competencies and registrations were not developed.
  • Patients we spoke with told us staff had treated them with compassion, kindness, dignity and respect.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Patients we spoke with advised that they found the appointment system had improved and reported that they were able to access care when they needed it. Some patients did comment on difficulties making future appointments.
  • The practice team displayed a willingness to learn and improve.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please refer to the requirement notice section at the end of the report for more detail).

The areas where the provider should make improvements are:

  • Undertake regular review and analysis of significant events and complaints to identify and trends and areas of risk or improvement.
  • Undertake regular fire drills.
  • Encourage eligible patients to undertake NHS health checks for those aged 40 to 74 years.
  • Continue with efforts to improve uptake of national cancer screening programmes.
  • Continue to identify and support carers in their population.
  • Continue with efforts to improve patient satisfaction and performance in the national GP patient survey; with particular regard for patient experience during GP consultations and with the telephone system.
  • Establish a structured meeting system for the practice team in line with staff feedback.

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

Inspection carried out on 10 February 2015

During a routine inspection

We carried out an announced comprehensive inspection at Dr Cassidy and Partners on 10 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be safe, effective, caring, responsive to people's needs and well-led. It was rated as good for providing services for older people, people with long-term conditions, families, children and younger people. It was also good at providing services for 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).

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • There were good links with other health providers in the area and there was evidence of multi-disciplinary working
  • 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 difficult to make an appointment, particularly when using the telephone system.
  • 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, particularly the active patient participation group, and it acted on this feedback.

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

Importantly the provider should

  • Actively monitor the impact of the newly implemented telephone system and the recently realigned appointment system to determine their effectiveness in meeting patients’ concerns about access to the practice.
  • Set out a clear, long-term strategy for the practice with objectives against which progress and improvements can be measured and ensure this is shared with staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice