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Archived: Grafton Medical Partners Good

Reports


Inspection carried out on 1 December 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Grafton Medical Partners on 19 April 2016 where the practice was rated good overall. However, breaches of regulation 17(1)(2) (Good governance) and 19(2)(3) (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified, and we rated the practice as requires improvement for providing safe services.

The specific concerns from the previous inspection related to safety were:

  • Not all staff had received thorough recruitment checks prior to employment.

  • There was no clear system in place for reporting and recording significant events. 

  • There was no clear system in place to identify action taken as a result of safety alerts.

  • There was no clear system in place to adequately monitor and manage assessed risks including those relating to health and safety, control of substances hazardous to health and Legionella.

  • Staff did not have access to regular mandatory training to be able to respond to emergencies, including annual basic life support training and fire safety training.

In addition to this, we found not all staff had received an annual appraisal and that multidisciplinary and clinical meetings were not always documented. Systems were not effective in identifying carers, and bereavement support information was not displayed in the waiting area. The complaints system needed to be reviewed to ensure it was clear for patients and staff, and in line with contractual obligations. The staffing structure, including roles and responsibilities were not clearly defined.

After the comprehensive inspection, the practice wrote to us with an action plan which outlined what they would do to meet the legal requirements in relation to the breaches of regulation.

We undertook this desk-based focussed inspection on 1 December 2016 to check that the practice had followed the action plan provided and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Grafton Medical Partners on our website at www.cqc.org.uk.

Overall the practice is rated as Good. Specifically, following the focussed inspection we found the practice to be good for providing safe services.

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

  • Adequate recruitment checks were undertaken prior to employment.

  • The practice had a clear system in place for reporting and recording significant events.

  • There was a clear system in place to identify action taken place as a result of safety alerts.

  • There was a clear system in place to adequately monitor and manage assessed risks including those relating to health and safety, control of substances hazardous to health and Legionella.

  • All staff had completed regular mandatory training to be able to respond to emergencies, including annual basic life support training and fire safety training.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection carried out on 19 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grafton Medical Partners on 19 April 2016. Overall the practice is rated as Good.

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

  • Staff understood their responsibilities to raise concerns, and to report incidents and near misses, however the system for reporting and recording significant events was not fully effective.
  • Risks to patients were assessed but not always 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 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 named GP and there was continuity of care, with urgent appointments available the same day, however some patients reported difficulty with getting through to the practice on the telephone.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There were governance systems in place and staff felt supported by leaders and managers in the practice.
  • 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 several areas of outstanding practice:

  • The practice commissioned a citizens advice service weekly due to the level of social needs required by the practice’s population group. This had been provided for the last two years.
  • The practice employed an in-house pharmacist to assist with medicine reviews, who specifically focussed on a review of prescribing for practice patients in a local nursing home. The practice were performing above the local Clinical Commissioning Group (CCG) target for antibiotic prescribing for 2015/16 and were one of the highest performers in the CCG area for anti-inflammatory safe prescribing.
  • The practice provided the over 75s with an information pack which included a booklet produced in conjunction with the Patient Participation Group (PPG), entitled ‘Local Services for Older People’. This contained detailed information about support and welfare services, social services, voluntary organisations and support for ethnic minority groups.

The areas where the provider must make improvement are:

  • Ensure that adequate recruitment checks are undertaken prior to employment.
  • Ensure that there is a clear system in place for reporting and recording significant events and a system for monitoring actions taken to improve safety in the practice.
  • Ensure that there is a system in place to identify action taken as a result of safety alerts.
  • Ensure that there are robust systems in place to adequately monitor and manage assessed risks including those relating to health and safety, control of substances hazardous to health and Legionella.
  • Ensure that staff have access to regular mandatory training to be able to respond to emergencies, including annual basic life support training and fire safety training.

In addition the provider should:

  • Ensure that staff receive an annual appraisal.
  • Ensure that multidisciplinary and clinical meetings are documented in order to record discussions, actions and to monitor patients effectively.
  • Ensure that the practice further refines practice systems to identify carers.
  • Provide bereavement support information for patients in the waiting area.
  • Review the complaints system to ensure it is clear for patients, staff and in line with contractual obligations.
  • Ensure that the staffing structure, including roles and responsibilities is defined, so that governance arrangements are more robust.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice