What is the Quality of Facilities at Shirley Medical Centre

Neutral

"The practice website can be accessed through The clinical team at the practice is made up of two fulltime male GP partners one parttime male GP partner one parttime female salaried GP and one parttime female longterm locum GP one parttime female locum nurse and one fulltime female healthcare assistant."

Positive

"There was no system of audit of the nurse prescriber’s clinical decision making."

Neutral

"There are two female practice nurses one who is employed and one who is a nurse prescriber a locum."

Neutral

"• There was a practice nurse who prescribed under Patient Group Directions PGDs."

Neutral

"There was also a nurse who had been recently employed as a nurse prescriber."

Neutral

"Some but not all of the anonymised records we saw showed that the nurse prescriber had consulted a GP before prescribing."

Neutral

"The practice had no evidence of the nurse prescriber’s competence to prescribe or of their agreed scope of practice."

Neutral

"• The practice had recently employed a nurse prescriber."

Neutral

"Staff gave us different accounts as to whether the nurse was prescribing in the practice and if so what they prescribed but evidence sent after the inspection showed that they were prescribing."

Neutral

"· Staff gave us different accounts as to whether the nurse prescriber was prescribing."

Neutral

"· There was no evidence of the nurse prescriber’s competence to prescribe or of their agreed scope of practice."

Positive

"Eighty eight percent of respondents said the last nurse they saw or spoke to was good at treating them with care and concern."

Neutral

"GP and nurse consultations were undertaken in consulting rooms which ensured privacy for patients."

Neutral

"For example the nurse was the lead for infection control and the lead GP was the lead for safeguarding."

Positive

"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."

Positive

"For example the practice did not have a robust system in place for monitoring patients on highrisk medicines."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"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."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"For example with monitoring of uncollected prescriptions the risks had not been fully identified with fire safety risks were identified but not acted upon and with recruitment the process had not been consistently implemented."

Positive

"For example with monitoring of uncollected prescriptions the risks had not been fully identified; with fire safety risks were identified but not acted upon; and with recruitment the process had not been consistently implemented."

Positive

"• Staff encouraged and supported patients to be involved in monitoring and managing their health."

Positive

"Not all staff had received annual appraisals and the system for monitoring training was not effective."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Neutral

"• There were arrangements for planning and monitoring the number and mix of staff needed."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"Management monitoring and improving outcomes for people The practice had systems in place to monitor and manage outcomes to help provide improved care."

Positive

"Our key findings were as follows: There were systems in place for reporting recording and monitoring significant events to help provide improved care."

Positive

"Learning and improvement from safety incidents The practice had an effective system in place for reporting recording and monitoring incidents and significant events."

Positive

"There was learning also for GPs to have an improved awareness of the cancer care review guideline and the importance for continuous monitoring and reviews."

Positive

"Staff were clear of their roles in regards to monitoring and reporting of incidents safeguarding vulnerable people and children and followed infection prevention and control guidelines."

Positive

"Health checks and health reviews were available to patients blood pressure taking and monitoring services medication advice and patient support and advice were all on offer."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"The practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."

Positive

"The practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."

Positive

"The practice is registered with CQC to carry out the regulated activities of diagnostics and screening procedures maternity services procedures family planning surgical procedures and the treatment of disease disorder or injury."

Positive

"The practice is registered with CQC to carry out the regulated activities of diagnostics and screening procedures maternity services procedures family planning surgical procedures and the treatment of disease disorder or injury."

Positive

"The practice is contracted for general medical services GMS and registered with the Care Quality Commission for the regulated activities of treatment of disease disorder or injury maternity services family planning surgical procedures and diagnostic and screening procedures at one location."

Neutral

"The practice’s website provided information ranging from the various services clinic times and newsletters to the various activities being undertaken by the practice and its services on offer."

Positive

"The provider had policies and procedures in place for safeguarding infection control and health and safety and a significant event policy and procedure."

Positive

"There was a named infection prevention and control officer within the practice who was responsible for cleanliness and infection control."

Positive

"Staff were clear of their roles in regards to monitoring and reporting of incidents safeguarding vulnerable people and children and followed infection prevention and control guidelines."

Neutral

"There were schedules in place for cleaning premises and equipment."

Positive

"We observed that the patient waiting room flooring was in a poor state of repair and required attention the seating that was available was not easily cleanable and though subject to regular cleaning within the cleaning schedule there was no way to safeguard patients from the risk of infection."

Neutral

"A cleaning schedule was in place with up to date records and evidence of cleaning audits being completed."

Neutral

"The practice had a regular cleaning schedule and records of the work being completed."

Positive

"Shortly after the inspection we were advised that a new system had been put in place for checking emergency medicines and supplies and that medicine for hypoglycaemia and pain relief had been ordered but not medicines for croup or for left ventricular failure."

Positive

"There was a system for receiving and acting on safety alerts such as patient and medicine safety alerts."

Positive

"Exception reporting is the removal of patients from QOF calculations where for example the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate."

Positive

"For example the work being completed in collaboration where all patients on the palliative care register are discussed to support and provide patients with appropriate care."

Positive

"These included diabetes management asthma medication and reviews palliative care and district nursing services."

Positive

"We reviewed a sample of care records and found that people with long term conditions such as diabetes and those with learning disabilities dementia palliative care and mental health disorders received regular care plan and medicines reviews."

Neutral

"Patients also had the option to make comments and suggestions within the practice and by external communications methods such as the internet and public health websites."

Positive

"The lead GP provided services in mental health care and was a mental health lead within the Croydon Clinical Commissioning Group CCG."

Neutral

"For example completing clinical audit cycles."

Positive

"The location’s facilities catered for the elderly and disabled patients providing good access and eye level reception desks."

Positive

"They told us that children vulnerable and elderly patients were given priority and were seen the same day by the GP."

Positive

"We saw that blood test results hospital discharge letters communications from other providers including out of hours provider were acted on promptly."