Kiveton Park Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kiveton Park Medical Practice on 9 December 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Records of actions taken could be improved.
• Risks to patients were assessed and well managed although some aspects of infection prevention and control (IPC) and records for monitoring temperatures of vaccine fridges could be improved.
• The provider had not obtained all the information required, prior to recruitment of staff, to ensure the person was of good character.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice provided a drop in service for patients aged between 12 and 25 years known as UCount2. The service was also available to patients from other local practices. The service had been provided for the past 15 years in response to demand in the local community and was guided by a committee which included young people from a local school. The service was situated away from the main waiting room in a separate building in the grounds of the practice to promote confidentiality. The service was provided by a nurse practitioner who had completed relevant additional training for this role. The nurse worked closely with the GPs, youth counsellor and youth worker to provide services twice a week during term time. The service included treatment, support and advice for sexual and health screening, teenage pregnancy, alcohol and drug use, relationship issues, eating disorders, mental health issues, sexual exploitation and minor illnesses. The nurse worked with parents and schools to support the young person as required. For example, in the case of a teenage pregnancy the nurse would offer to liaise with parents/carers at the surgery or at home to discuss support and follow-up care. We saw communication from the CCG which showed this service had been identified by the CCG as one of the key strengths of the practice. The CCG had also stated that the outcomes for young people using the service were good and that the teenage pregnancy rate for the area was low.

The areas where the provider must make improvement are:

• The provider had not obtained disclosure and barring service (DBS) checks prior to employment for staff such as nurses and a phlebotomist who worked alone with patients.

The areas where the provider should make improvement are:

• Records, including meeting minutes, did not always clearly identify the actions taken in response to significant events and safety alerts.

• There were some shortfalls in IPC systems. For example, sharps bins were not signed, clinical waste bags were not labelled, no evidence of a cleaning regime for ear irrigation equipment, practice cleaning records did not evidence which task had been completed and by who and a foot operated bin was not provided in the staff toilet.

• There were no written procedures for monitoring and recording the temperature of vaccine fridges and records of temperature checks were not maintained in sufficient detail.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice