Archived: Chapel Street Medical Centre

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Chapel Street Medical Centre on 21 April 2015. We found that the practice was performing at a level which led to a ratings judgement of requires improvement.

Our key findings were as follows:

Specifically, we found the practice to be good for providing a caring and responsive service. It requires improvement for providing a safe, effective and well led service for the population groups we assess.

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

• The practice used a range of information to identify risks and improve patient safety and staff understood their responsibilities to raise concerns.
• Staff were trained in safeguarding procedures and knew to report abuse to a senior member of staff.
• Systems are in place to manage medicines safely. However, improvements need to be made to the way information about patients’ medicines is transferred into their case notes following a hospital visit.
• Equipment such as disposable gloves and aprons were available to protect staff from exposure to potential infections.
• Patients told us that they were treated with respect and described the reception staff as helpful, welcoming and polite. They said the GPs and nurses provided excellent care and they were treated with dignity and respect.
• Patients who experienced mental health problems were referred to a counselling service or support agency for emotional support.
• The practice had access to translation services for patients whose first language was not English
• Staff received training appropriate to their roles.
• The practice worked with other health care professionals to support continuity of care for patients.
• There was a leadership structure in place and staff were supported by management. However, some improvements were needed to ensure ongoing improvement to the service including the review of significant events and clinical audits for the purpose of improving outcomes for patients.

Importantly the provider must:

• Ensure governance systems are in place that bring about improvements to the service including the review of significant events for the purpose of learning, providing an annual health check to patients with a learning disability and improving the appointment system so that patients can access the service more easily.

However, there were also areas of practice where the provider needs to make improvements. In addition the provider should:

• Ensure a full cycle of clinical auditing takes place to ensure positive outcomes for patients.
• Ensure there is a way of alerting staff to potential safeguarding situations.
• Ensure there is a system in place of transferring patients on the child protection register to the new practice.
• Ensure there is a way of monitoring patients when repeat prescriptions are not collected.
• Ensure improvements are made to the way information about patients’ medicines is transferred into their case notes following a hospital visit.
• Ensure a more thorough system is set up to recall patients who do not attend appointments.
• Ensure GPs receive training on the use of the Mental Capacity Act 2005.
• Ensure complaints are formally audited to identify trends and patterns in order to preventing complaints from re occurring.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice