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Olive Medical Practice Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 28 January 2020

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Olive Medical Practice on 25 September 2019. The inspection identified shortfalls in meeting the required standards and the practice was rated as Requires Improvement overall with key question Safe and population group Working age people (including those recently retired and students) rated as inadequate. The key questions Effective, Caring, Responsive, Well Led and the other population groups were rated as requires improvement. We issued a warning notice for breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and treatment).

The full comprehensive report for the September 2019 inspection can be found by selecting the ‘all reports’ link for Olive Medical Practice on our website at

This inspection was an announced focused inspection carried out on 28 January 2020 to assess the progress achieved by the practice in implementing their plan to meet the legal requirements identified in the warning notice for breach of regulation 12. We did not rate the service or key question Safe at this inspection. The practice rating remains Requires improvement overall. A further comprehensive inspection will be carried out in the near future in accordance with our inspection methodology to further monitor improvements and update the practice ratings accordingly.

At this inspection we found:

  • Good progress in meeting the requirements of the warning notice had been achieved.
  • Evidence presented demonstrated positive achievement and progress in improving safeguarding processes. Work alongside the clinical commissioning group (CCG) safeguarding team and other GP practices in the locality was in progress to ensure clear and consistent record keeping and patient safeguarding coding was established.
  • The practice now implemented ‘did not attend appointment’ and ‘child not brought to appointment’ policies. The implementation of the policies was subject to weekly checks and monthly audits to ensure patients who had missed appointments were followed up.
  • There was now a system for reviewing test results, including cytology, in a timely manner, which had resulted in no backlog of results waiting to be reviewed.
  • The practice was part of a pilot scheme whereby correspondence work flow was reviewed and sorted at a ‘hub’ location. At the time of this visit, the hub had experienced some problems which resulted in a backlog of electronic correspondence for the practice to review. The hub had assured the practice that all urgent correspondence had been responded to and actioned. A plan to address the backlog of correspondence was being implemented.
  • Monitoring of the decision making of those working in advanced clinical roles was established.
  • Systems to monitor, review and respond to patient safety alerts were comprehensive and effective.

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 25 September 2019

During a routine inspection

We carried out an announced comprehensive inspection at Olive Medical Practice on 25 September 2019. This was the first inspection of this service for this provider. The GP partnership providing the services at Olive Medical Practice took over the NHS contract in November 2018 and completed their registration with the CQC in August 2019.

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.

The GP practice was previously registered under a different provider and rated inadequate. The current registered GP partnership renamed the practice to Olive Medical Practice. The practice team were committed to improving the service they provided and were implementing a range of action plans to improve the quality and safety of the service provided.

We rated the practice as inadequate for providing safe services because:

  • Processes around coding patients on the safeguarding register were incomplete.
  • Action to follow up patients who did not attend appointments including those with a child protection plan in place was not undertaken
  • Timely action in responding to patient reports and allocated clinical tasks was not evident and action to ‘complete’ actioned tasks was not implemented consistently.
  • Timely action reviewing test results, including cytology reports was not evident.
  • Monitoring of the decision making of those working in advanced clinical roles was not established.
  • Systems to respond to patient safety alerts were not comprehensive.

We rated the practice as requires improvement for providing effective, caring, responsive and well led services and five of the population groups because:

  • Some performance data was below target levels, including children’s immunisation
  • Feedback through the patient survey was below that of the local and England averages.
  • Patient feedback indicated concerns with appointment and telephone access. The practice had responded to this by providing more appointments and introducing a patient ‘query’ system.
  • Comprehensive quality improvement action plans were being implemented.
  • The practice team were positive and enthusiastic. They told us there had been a cultural shift to inclusive team work and they were all working together to provide a quality service with patients.

We rated the practice inadequate for services provided for population group Working age people (including those recently retired and students) because:

  • There were gaps in the range of services available to this group of patients
  • Cervical screening was significantly below national averages

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Make available a child pulse oximeter.
  • Take action to improve the records of patients who are also carers
  • Take action to improve achievements for cervical screening and immunisations children.
  • Take action to remove signage including electronic information relation the previous name of the GP surgery.

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