Dr C J Studds and Partners Also known as Meadowside Medical Centre

We carried out an announced comprehensive inspection at Dr Studds and Partners (also known as Meadowside Medical Centre) on 4 February 2020 as part of our inspection programme.

At this inspection we followed up on breaches of regulations identified at a previous inspection on 9 January 2019.

This inspection looked at the following key questions:

Safe

Effective

Caring

Responsive

Well-led

At the last inspection in January 2019 we rated the practice as requires improvement for providing safe and well-led services because: There was a lack of systems and processes established and operated effectively to ensure compliance with requirements to demonstrate good governance. There were a lack of systems and processes to demonstrate the provider was doing all that was reasonably practicable to mitigate risks. The monitoring of the training needs of staff to enable them to carry out their roles and responsibilities appropriately and safely was not effective. Policies and procedures were not reviewed to ensure they were in line with current best practice. Internal audits were not effectively used to support improvement and mitigate risk. Some infection control practices required improvement. There was no documentary evidence to show that the competency of staff trained to carry out extended health care roles had been assessed. The monitoring of the temperatures of vaccine fridges was not effective. Meetings were not appropriately recorded and there was no evidence that learning and actions from incidents were shared with the whole staff team.

At this inspection we found that the provider had satisfactorily addressed the above areas.

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 good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of good quality, person-centre care.

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

• Review the system in place for managing safety alerts to ensure this is robust and demonstrates the actions taken.
• Review safeguarding arrangements to include setting up an alert for relevant others for children at risk.
• Review the arrangements for ensuring health checks have been carried out prior to prescribing high risk medicines.
• Introduce a programme of clinical audit in an aim to improve outcomes for patients.
• Review the emergency medicines held and ensure an appropriate risk assessment has been carried out if required.

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

We carried out an announced comprehensive inspection at Dr C J Studds and Partners (Meadowside Medical Centre) on 9 January 2019 as part of our inspection programme.

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.

The overall rating for this practice was requires improvement due to concerns in providing safe and well-led services. However, the population groups were rated as good because patients were able to access timely and effective care and treatment.

We rated the practice as requires improvement for providing safe services because:

• There was no documentary evidence to show that the competency of staff trained to carry out extended health care roles was assessed and monitored.
• Patient Specific Directives had not been authorised appropriately.
• The monitoring of the temperatures of vaccine fridges was not effective.
• There was no documentary evidence that showed learning and action taken from incidents had been shared with the whole staff team.

We rated the practice as requires improvement for providing well led services:

• The overall governance arrangements in place were limited and did not support an overview of the performance of the service.
• Policies and procedures were not reviewed to reflect current good practice for example, the infection prevention control policy and safeguarding.
• Training needs were not always being appropriately identified and actioned for example, Mental Capacity Act, health and safety and safeguarding children training.
• There were limited quality assurance systems in place to support service improvement and safety.

We rated the practice as good for providing effective, caring and responsive services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• Care and treatment was delivered in line with standards and evidence-based guidance supported by clear pathways and tools.

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:

• Suitable training should be provided to the health and safety lead to ensure the risk assessments meet current legal requirements.
• A system to ensure blank prescriptions held in printers are logged and secured when the practice was closed should be introduced.
• The practice should review how patient electronic information was stored to ensure it is only held on/in patient records.

Chief inspector