Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at York House Medical Centre on 7 July 2016. The overall rating for the practice was requires improvement. Specifically, we found the practice to require improvement for the provision of safe and responsive services. The practice was rated good for providing effective, caring and well-led services. The concerns identified as requiring improvement affected all patients and all population groups were also rated as requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for York House Medical Centre on our website at www.cqc.org.uk.
This inspection was an announced focused inspection carried out on 23 August 2016 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 7 July 2016.
This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
Overall the practice is now rated as good. However, provision of responsive services remains rated as requires improvement.
Our key findings were as follows:
- The process for reporting significant events had improved to include an online reporting form. Sharing of learning from significant events had expanded to include the practice nurses and salaried GPs. However, not all events were shared with the non-clinical staff.
- Legionella risk assessments had been carried out. Monitoring of water temperatures was carried out as a result of the assessment to reduce the risk of waterborne infections.
- Actions had been taken arising from the fire risk assessment. For example, we saw fire drills were undertaken and recorded.
- Monitoring of medicine fridge temperatures was undertaken consistently to ensure medicines requiring refrigeration were maintained within appropriate temperature ranges.
- All relevant pre-employment checks were being carried out before new staff joined the practice.
- There was a system in place to ensure blank prescriptions were stored and distributed for use in a secure manner.
- Minutes of staff meetings were recorded consistently and made available to staff via the practice computer network.
- Mandatory training had been completed by all staff. There was system in place to ensure training was completed at relevant intervals and training was available through a variety of sources.
- Feedback from patients taking part in the national patient survey in regard to accessing services was below average. The practice had not undertaken a review of the appointments system to review availability against demand.
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
In addition the provider should:
- Review the dissemination of learning from significant events to the wider practice team.
- Review the range of medicines held to deal with medical emergencies and consider the needs of all registered patients who may encounter a medical emergency.
At our previous inspection on 7 July 2016, we rated the practice as requires improvement for providing responsive services as feedback from patients in regard to access to appointments was below average. At this inspection we found that feedback from patients remained below average. The actions taken by the provider to address this were in the process of implementation and it was too early to evaluate whether these would result in improved patient feedback. Consequently, the practice is still rated as requires improvement for providing responsive services.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice