Archived: Moakes Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Moakes Medical Centre on 05 July 2016. Overall the practice is rated as good.

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

• The practice had a clear vision and had recognised the particular needs of patients in the community it served.

• The practice had worked to create an open and transparent approach to safety. A clear system, which was made known to all staff, was in place for reporting and recording significant events.
• Risks to patients were identified, assessed and appropriately managed. For example, the practice implemented appropriate recruitment checks for new staff, undertook regular clinical reviews and followed up-to-date medicines management protocols. However, systems for processing deliveries of medicines should be improved. Additionally, thorough records for fire drills and building evacuation should be maintained.
• We saw that the staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were supported to access development learning and routine training was provided to ensure they had the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients was consistently positive. Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Comments from patients on the 27 completed CQC comment cards confirmed these views.
• Results from the GP Patient Survey January 2016 were generally positive, with some outcomes higher than local and national outcomes. For example, 79% of patients described their experience of the surgery as good.
• Information about services and how to complain or provide feedback was available in the waiting area and published on the practice website. Where appropriate improvements were made to the quality of care as a result of complaints and concerns. Outcomes from complaints were shared and learning opportunities identified as appropriate.
• The practice had only 0.5% of carers recorded from its patient list and should look to increase this number.
• Appointments were readily available. Urgent appointments were available the same day, although not always with the patients named or usual GP. For example, 72% of patients described their experience of making an appointment as good.
• The practice shared a purpose built, modern building with other care providers. They had access to good facilities and modern equipment in order to treat patients and meet their needs.

• There was a clear leadership structure and we noted there was positive outlook among the staff, with good levels of moral in the practice. Staff said they felt supported by management. The practice business plan should be updated to reflect local objectives.

• The practice proactively sought feedback from staff and patients in a variety of ways, which it acted on.

• The social prescribing project had enabled the practice to reach out to patients and offer support and advice to improve health and non-clinical elements of their lives.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are as follows:

• To implement a system to ensure that deliveries of medicines and vaccinations are refrigerated in accordance with appropriate guidelines and to maintain a written record of action taken.
• Records of fire drills and building evacuation arrangements should be maintained.
• The business development plan in place at the practice was corporately produced by the provider and would benefit from review and evaluation of progress against specific local objectives.
• The developmental outreach work, designed to identify and support patients with caring responsibilities should continue.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice