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Elbury Moor Medical Centre Requires improvement

Reports


Inspection carried out on 17 Oct 2019

During an inspection to make sure that the improvements required had been made

We carried out an inspection of this service on 17 October 2019 following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

This inspection focused on the following key questions: Effective and Well-led.

In view of the assurance received from our review of information, we carried forward the ratings for the following key questions: Safe, Caring and Responsive.

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 and good for all population groups with the exception of families, children and young people and working age people (including those recently retired and students).

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

We found that:

  • The practice’s uptake of the childhood immunisations rates was below the national averages for all of the four immunisations measured.
  • The practice’s uptake of the national screening programme for cervical cancer was below the local and the national averages.
  • Data showed higher than average quality and outcomes framework (QOF) exception reporting and inconsistencies in the practice processes.
  • Risks to patients were assessed and well managed.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was a clear leadership structure and staff felt supported by the management.
  • Leaders did not always have a clear picture of performance and systems of review and audit had not been effectively implemented.
  • The practice had demonstrated good governance in most areas, however, they were required to make further improvements.
  • The practice had already identified and taken steps to address many of the issues raised during our inspection but as actions had been recent and they were unable to demonstrate the impact or effectiveness.

Whilst we found no breaches of regulations, the provider should:

  • Continue to work on reducing the prescribing of hypnotics and antibiotics.
  • Continue work to increase the uptake for cervical, breast and bowel screening.
  • Continue with actions to increase the uptake for immunisations.
  • Continue to take actions to improve performance and ensure patients receive care and treatment that meets their needs.
  • Continue to take steps to increase an audit programme of quality 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 13 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Turner and Partners on 13 April 2016. Overall the practice is rated as good.

Our key findings across all of 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 and all staff had access to the template for recording incidents.

  • Staffing levels were monitored to ensure they matched patients’ needs. In response to a shortage of GPs and lower than average scores in the national patient survey around availability of appointments the practice had put systems in place. Efforts were being made to employ another GP and more nursing staff and to change the way nurses worked to address the problem.

  • Safe arrangements were in place for staff recruitment that protected patients from risks of harm.

  • Patients were protected by a comprehensive safety system. There was focus on openness, transparency and learning when things went wrong. Arrangements were in place to ensure that the premises and equipment were hygienically maintained.

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Risk assessments were included for those patients who had care plans in place. Staff had received training appropriate to their roles and any further training had been identified, planned and implemented.

  • Patients told us they were treated with compassion, dignity and respect and they were involved in decisions about their treatment. Observations during our inspection showed that staff were courteous and helpful towards patients.

  • Information about how to make a complaint was readily available and easy to understand. Staff demonstrated that complaints received were dealt with appropriately.

  • The practice had purpose built premises and facilities and was well equipped to assess and treat patients.

  • There was a clear leadership structure and staff told us they felt well supported by senior staff. Management proactively sought feedback from patients which it acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 8 November 2013

During a routine inspection

During our inspection we spoke with 11 patients and eight members of staff.

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. A patient said: "They're all fabulous. They use your name so you get a personal approach".

The patients we spoke with provided positive feedback about their care. A patient told us: "Absolutely top class. The care I've had over the last few years is great". Patients who received regular medicines told us they were regularly reviewed to check that they still needed them.

Staff had received training in safeguarding children and vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from harm.

We found that staff had received appropriate training for the roles they carried out. They also had received annual appraisals. This meant that they had been adequately assessed as being competent.

The provider had systems in place for monitoring the quality of service provision. There was an established system to regularly obtain opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.