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Forest Health Group Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 July 2019

We carried out an announced comprehensive inspection of Forest End Medical Centre on 1 May 2019 as part of our inspection programme.

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 requires improvement overall. We have rated Safe, Effective and Well led as requires improvement and Caring and Responsive as good. We have rated all the population groups as requires improvement.

We rated the practice as requires improvement for providing safe services because:

  • The practice did not have oversight of safety risk assessments at one of the sites (including fire, legionella and infection control). They had not completed their own risk assessment for legionella at one site and had not undertaken any precautionary checks for legionella at the main site.
  • Emergency medicines stock at all sites had not been risk assessed to identify any gaps in provision (or mitigate the need for them).
  • Staff had not been assessed for any medical conditions, that may affect their work, so reasonable adjustments could be made.
  • Non clinical staff had limited knowledge of significant events identification or escalation processes.

We rated the practice as requires improvement for providing effective services because:

  • Staff had not received regular appraisals to identify learning needs and review performance and there were gaps in staff training including safeguarding, infection control and fire safety.
  • There were no formal arrangements in place for continuing clinical supervision of non-medical prescribers.

We rated the practice as requires improvement for providing well led services because:

  • Governance arrangements required a review as these were inconsistently applied. Risks and areas of concern were not always identified or effectively managed.
  • Staff told us the merger had been challenging and they did not feel involved in decisions about the practice.
  • Not all staff were clear about lead roles or who to approach for support and information.

These requires improvement areas impacted all population groups and so we rated all population groups as requires improvement.

We rated the practice as good for providing caring and responsive services because:

  • 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. Most patients could access care and treatment in a timely way.

The areas where the provider must make improvements are:

  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Review the recommendations of the “green book” in relation to staff immunisation status and consider if non-clinical staff should have their status assessed and documented.
  • Continue to review and monitor QOF achievement and exception reporting for diabetes indicators.
  • Consider the risks of the sit and wait service in relation to assessing urgent patient needs and staff training for recognising serious illness (including sepsis).
  • Review and monitor cervical screening uptake rates and continue to encourage eligible women to attend for screening.
  • Improve the identification of carers to enable this group of patients to access the care and support they need.
  • Review the arrangements for updating staff across all sites about changes in staffing and leadership.

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 areas

Safe

Requires improvement

Updated 10 July 2019

Effective

Requires improvement

Updated 10 July 2019

Caring

Good

Updated 10 July 2019

Responsive

Good

Updated 10 July 2019

Well-led

Requires improvement

Updated 10 July 2019

Checks on specific services

People with long term conditions

Requires improvement

Updated 10 July 2019

Families, children and young people

Requires improvement

Updated 10 July 2019

Older people

Requires improvement

Updated 10 July 2019

Working age people (including those recently retired and students)

Requires improvement

Updated 10 July 2019

People experiencing poor mental health (including people with dementia)

Requires improvement

Updated 10 July 2019

People whose circumstances may make them vulnerable

Requires improvement

Updated 10 July 2019