The Care Quality Commission
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Archived: Taw Hill Medical Practice

Overall: Good read more about inspection ratings

Taw Hill Medical Centre, Aiken Road, Swindon, Wiltshire, SN25 1UH (01793) 709500

Provided and run by:
Taw Hill Medical Practice

Important: The provider of this service changed. See new profile

All Inspections

5 August 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focussed inspection at Taw Hill Medical Centre on 5 August 2015 to follow up on actions identified during out previous inspection in October 2014. Aspects of the practice we asked the provider to improve which were covered during our inspection included; staff recruitment, the safety and availability of equipment, medicines management and quality assurance processes. We saw the provider had made improvements to their service; overall the practice is rated as good.

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, with improvements to those relating to recruitment checks, medicines management and emergency equipment.
  • Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • 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.
  • 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 sought feedback from staff and patients, which it acted on and quality assurance processes had improved.

We saw one area of outstanding practice:

  • The phlebotomist’s role had been extended to improve outcomes for patients. Alongside blood tests they took the patient’s blood pressure, measured their weight, recorded their body mass index and recorded their smoking status. Where concerns were noted the GP was informed and a further appointment was made. This helped the practice to proactively work towards preventing patients acquiring longer term conditions.

However there were areas of practice where the provider could make improvements. Importantly the provider should;

  • Ensure all newly appointed staff have their induction training prioritised so that key subjects such as safeguarding and mental capacity are covered earlier in their induction.
  • Ensure more frequent supervision of nurse prescribers is arranged and implemented.
  • Ensure monthly infection control checks are recorded to evidence the work carried out.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

21 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

Taw Hill Medical Practice is located in purpose built premises in a semi-rural location. It provides services to approximately 12,000 registered patients. The practice dispenses prescriptions to approximately half of its patients.

We carried out an announced, comprehensive inspection on 21 October 2014. We visited the practice location at Aiken Road. Swindon. Wiltshire. N25 1UH.

Overall we have rated the practice as ‘Requires Improvement’.

Our key findings were as follows:

  • Patients told us they were happy with the care and support provided by the GPs and nurses and their involvement in decision making about their health and wellbeing.
  • Aspects of safe practice were not in place. For example, recruitment processes did not include criminal records checks for all nurses and GPs or risk assessments for staff involved in chaperone support. In addition, emergency medicines and associated equipment were not checked to see if they were safe to use.
  • Patients’ privacy and dignity were maintained and patients’ cultural background and human rights were respected
  • The practice did not have processes in place which ensured learning was taken from incidents or complaints, audits or the learning and development needs of staff to improve the performance of the practice.
  • The practice worked in partnership with other organisations such as the NHS local area team and clinical commissioning group (CCG), the out of hours GP service and other practices to help improve access to GPs for patients in the local area.
  • Governance arrangements were not in place for several areas relating to the management of the practice. There were no clear decision making pathways which enabled all staff to be clear about their role responsibilities and no forum for staff to raise concerns or suggestions for improvements. Risk management took place in regard of the premises but did not include succession planning, performance or quality management and assurance.
  • Patients spoke positively about the effectiveness of their treatment and how the GPs and nurses enabled their health to improve or be maintained. Patients told us they could access appointments at a time which suited them and the quality of their treatment was good. However some comments made by other patients using the NHS Choices website indicated they were dissatisfied with access to appointments.

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

Importantly, the provider must:

  • Review its recruitment policy and processes particularly in relation to obtaining criminal records checks
  • Undertake risk assessments for employee roles which do not require a criminal records check and who may be required to act as a chaperone for vulnerable patients.
  • Monitor emergency medicines to ensure they are within expiry dates and equipment, including first aid equipment, is well maintained
  • Review its quality assurance processes to ensure there are effective systems in place to monitor and manage the quality of services to patients. For example, significant events, complaints, patient and staff feedback, training, legionella testing and providing support and appraisals to all staff.

In addition the provider should:

  • Consider how it manages and provides hand hygiene facilities to its patients.
  • The practice should have better systems in place to ensure the day to day stock control of medicines and prescription pads is monitored.
  • The practice should establish and develop its patient participation group as a way of gathering patient feedback.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

11 November 2013

During a routine inspection

During our inspection with spoke with four people who used the service. Everyone we spoke with told us that overall they were satisfied with the service they received and had confidence in the abilities of the GPs and nurses. We found that although the practice was busy the majority of patients could get an appointment when they needed one, including the same day. One patient said 'it's quite easy to get an appointment, if I want to see a certain GP then I may have to wait a little longer but I don't mind'.

One patient we spoke with told us 'they are all very good here, this is one of if not the best surgery I have attended. Another patient told us 'I am generally happy with the treatment I receive'.

Patient's views were taken into account in the way the service was provided and delivered in relation to their care. The provider took adequate steps to ensure that patients were protected against the risks of receiving care or treatment that was inappropriate or unsafe.

We found clinical and non-clinical areas were clean and tidy and free from odours. Patients we spoke with said they had no concerns about hygiene standards within the practice. They told us that the GPs and nurses always wore the correct protective equipment, such as gloves, whilst examinations took place.

The provider and practice manager were aware of the need to assure themselves that new staff were recruited correctly.

During our visit we found the practice had sought the views of patients and acted upon the feedback received. The practice undertook periodical clinical and non-clinical audits throughout the year.