- GP practice
Archived: Walton Surgery Also known as Walton Medical Centre
Important:
The provider of this service changed. See new profile
All Inspections
23 November 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out a comprehensive inspection at Walton Surgery on 16 June 2015. The practice was rated as requires improvement overall. Specifically they were rated as requires improvement for safe, effective and well-led services and good for providing a caring and responsive service.
In particular, on 16 June 2015, we found the following areas of concern:
- There was no audit trail that reflected that following incidents or concerns being raised improvement action had been taken.
- Infection control audits were not being carried out in line with recommended timescales.
- Risk relating to the management of medicines, medicines alerts, prescription reviews and stocks of emergency medicines were not being assessed.
- A legionella risk assessment had not been carried out.
- Reception staff acting as chaperones had not received a disclosure and barring service (DBS) check.
- Staff were unclear which training they were expected to undertake and when it was due.
- Annual appraisals had been undertaken for clinical staff but not for administration staff.
- Data showed patient outcomes were average for the locality but where the Quality and Outcomes Framework was not being used there was no other performance measure in place.
- The practice had not sought views from patients in the form of a survey or by other means.
As a result of our findings at this inspection we took regulatory action against the provider and issued them with requirement notices for improvement.
Following the inspection on 16 June 2015 the practice sent us an action plan that explained what actions they would take to meet the regulations in relation to the breaches of regulations.
We carried out a further comprehensive inspection at Walton Surgery on 23 November 2016 to check whether the practice had made the required improvements. We found that the majority of the improvements had been made across all areas of concern. Overall the practice is now rated as good.
Our key findings across all the areas we inspected were as follows:
- Staff were aware of their responsibilities regarding safety, and reporting and recording of significant events. There were policies and procedures in place to support this.
- The practice assessed risks to patients and staff. There were systems in place to manage these risks.
- Processes and systems around medicines management kept patients safe.
- Staff used current guidelines and best practice to inform the care and treatment they provided to patients.
- All patients said that they were treated with dignity and respect and involved in decisions about their care and treatment.
- There was a clear and effective complaints system in place.
- Patients had mixed views regarding access to appointments. Getting through on the telephone in the morning was identified as an issue by some patients. Others told us that access to same day appointments was good.
- The practice had difficulty recruiting GPs to the practice and had reviewed the way it provided clinical services to meet the needs of its patient population.
- There was a strong leadership structure in place and staff were supported to increase their knowledge and skills. Appraisals for non-clinical staff were not taking place, however we saw evidence that they still had access to training and career progression.
- There was an open and transparent approach evident throughout the practice. The practice management were aware of both their strengths and areas for improvement and had incorporated this into their planning for the future.
However, there were also areas of practice where the provider needs to make improvements.
The provider should:
- Provide non-clinical staff with regular performance appraisals.
- Improve access to appointments via telephone.
- Improve the monitoring of patients with poor mental health.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
16 June 2015
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Walton Surgery on 16 June 2015. Overall the practice is rated as requires improvement.
Specifically, we found the practice to require improvement for providing safe, effective and well-led services. It also required improvement for providing services for all of the population groups. It was good for providing a caring and responsive service.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. There was no audit trail that reflected that improvement action had been taken.
- Risks to patients were assessed and well managed, with the exception of those relating to the management of medicines, medicines alerts, prescription reviews and stocks of emergency medicines. A legionella risk assessment had not been carried out.
- Infection control audits were not being carried out in line with recommended timescales.
- Staff training met the needs of patients but it was unclear to staff which training they were expected to undertake and when it was due.
- All staff undertaking chaperone training had been appropriately trained but disclosure and barring service (DBS) checks had not been undertaken for reception staff caring out these duties.
- Recruitment processes were robust and staff were suitably qualified and skilled.
- Annual appraisals had been undertaken for clinical staff but not for administration staff.
- Data showed patient outcomes were average for the locality but where the Quality and Outcomes Framework was not being used there was no other performance measure in place.
- Patients said they were treated with compassion, dignity and respect and they were involved in the decisions about their care and treatment.
- The national GP survey results published in 2015 reflected that patients were satisfied with the majority of the services provided.
- Information about services and how to complain was available and easy to understand.
- The practice had prioritised services for older people and allocated additional resources to home visits and consultations for patients residing in care homes.
- The practice had policies and procedures in place and provided staff with a handbook to support them in understanding how the practice was managed and the standards expected of them.
- The practice had a productive relationship with the patient participation group but had not sought views from patients in the form of a survey or by other means.
The areas where the provider must make improvements are:
- Review the system for managing national patient safety and medicine alerts so that there is an audit trail for action and that audits take place periodically.
- Review the system for the review of repeat prescriptions and medicines that are high risk and ensure that patient records are accurately coded to reflect that blood tests and reviews had taken place.
- Undertake DBS checks for all staff undertaking chaperone duties or record a rationale or risk assessment that makes it clear why one is not necessary.
- Undertake a legionella risk assessment.
In addition the provider should:
- Review the system for the monitoring of emergency medicines.
- Implement the actions identified in the health and safety risk assessment from 2013 and record environmental quality checks when they take place.
- Maintain records to evidence that an induction process has taken place and completed satisfactorily by new members of staff, locum GPs and locum nurses. Ensure all staff receive an annual appraisal and that registration checks their professional bodies take place.
- Ensure that staff training identifies the type and frequency required for the different staff groups and that it is being undertaken.
- Implement a monitoring system to ensure care and treatment is effective for those clinical areas not the subject of monitoring using the Quality and Outcomes Framework.
- Assess and monitor the services provided by obtaining feedback from patients, undertaking clinical and non-clinical audits and infection control audits in line with recommended intervals.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
23 October 2013
During a routine inspection
We found that before people received any care or treatment they were asked for their consent and the clinicians acted in accordance with their wishes. One person we spoke with said, 'They ask for my consent before an intervention and if you say no they don't push you.'
We saw that the surgery worked proactively with a range of other providers including audiology and end of life care professionals. One person we spoke with told us, 'I was referred to hospital as an emergency. It happened smoothly and I felt well looked after.'
We spoke with five members of staff, all of whom felt well supported. We spoke with two nurse practitioners who told us, 'Either of us is always here, so that staff have someone to come to.'
We saw that the surgery had an effective system in place to assess and monitor the quality of the service and ensured that information was shared with people who used the surgery. One person we spoke with told us, 'It's a good practice, even under the pressure, with the shortage of GPs.'