This practice is rated as Requires Improvement overall. (Previous inspection October 2014 rated as Good)
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Requires Improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires Improvement
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Requires improvement
People with long-term conditions – Requires improvement
Families, children and young people – Requires improvement
Working age people (including those recently retired and students) – Requires improvement
People whose circumstances may make them vulnerable – Requires improvement
People experiencing poor mental health (including people living with dementia) - Requires improvement
We carried out an announced comprehensive inspection at The Whitfield Practice on 29 March 2018 as part of our inspection programme.
At this inspection we found:
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The practice had some systems to manage risk so that safety incidents were less likely to happen, for example, when incidents did happen, the practice learned from them and improved their processes. However, the practice had not completed risk assessments in relation to health and safety matters and had not assured themselves staff had completed training in these areas.
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Recruitment procedures had not been consistently implemented and not all the required checks had been completed prior to employment.
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
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The practice had faced a number of challenges in the last 12 months and was aware improvements were required. They had reviewed their staffing provision to manage the significant partnership changes and the imminent retirement of the practice manager. They had employed a clinical pharmacist partner and staff were moving in to new roles to address this. Staff had, and were continuing to, work hard to ensure the impact on patients was minimised during the changes.
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The practice made use of internal and external reviews of incidents and complaints. Learning was shared and used to make improvements.
The areas where the provider must make improvements as they are in breach of regulations are:
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Ensure care and treatment is provided in a safe way to patients.
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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.
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Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
The areas where the provider should make improvements are:
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Review and improve systems to support duty of candour requirements.
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Review and improve access to the records relating to the vaccine refrigerator temperatures to make all the data accessible to relevant staff.
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Review and improve cover arrangements for administration processes when staff are on leave.
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Review and formalise management arrangements and clinical overview of information received about patients who have attended out of hours and accident and emergency services.
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Review and improve management oversight of medical alerts.
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Review and improve the security of blank prescriptions held in consulting rooms.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice