We carried out an announced comprehensive inspection at Griffiths Drive Medical Practice on 20 September 2022. Overall, the practice is rated as good.
Safe - good
Effective - good
Caring - good
Responsive - good
Well-led - good
This is the first inspection of Griffiths Drive Medical Practice following its registration in June 2021 and includes the safe, effective, caring, responsive and well-led key questions.
Why we carried out this inspection
We carried out this inspection as part of our regulatory inspection process.
How we carried out the inspection:
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A site visit.
Our findings
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 found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Staff demonstrated awareness of actions required if they suspected safeguarding concerns.
- Staff files were not all organised so that relevant documents were readily and easily accessible in one place.
- We found that the immunisation status of all staff was not consistently available to demonstrate any immunisation that was incomplete.
- The practice had a system for recording and disseminating actions carried out as a result of significant events to support learning and improvement.
- The practice had taken appropriate action to support and protect patients identified as at risk from harm.
- Patients received effective care and treatment that met their needs.
- There were some gaps in the documentation of a patients review to show clearly details of the review and its outcome.
- There was a below average uptake by patients of preventative treatments in particular, childhood immunisations and cervical screening.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The results of the National GP Patients survey identified that patients had a positive experience of the practice and felt there was access to timely care and treatment.
- The provider had updated its telephone system to improve patient access to the practice.
- The practice had management oversight of staff qualifications and training.
- Staff were clear and knowledgeable about their lead roles and responsibilities.
- Effective governance arrangements had been implemented to mitigate risks and ensure patients were kept safe.
- The way the practice was led and managed promoted an inclusive culture where people could speak openly and be involved in the delivery of high-quality, person-centred care.
Whilst we found no breaches of regulations, the provider should:
- Continue to develop and improve the recruitment processes and standard of staff documentation held.
- Provide evidence that staff vaccination and immunity for potential health care acquired infections are recorded or risk assessed for all staff.
- Introduce processes for the ongoing review and follow up of safety alerts to demonstrate that any changes or action taken in response to the alert is maintained.
- Improve the uptake of childhood immunisations and cervical cancer screening.
- Continue to proactively identify carers so that they can be supported to access services available to them.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services