Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Adderley Green Surgery on 8 August 2017. Overall the practice is rated as good.

Dr Sridharaprumal Shanmugasundaram was formally registered with the Care Quality Commission (CQC) as a single handed GP practice known as Adderley Green Surgery located at Weston Street, Adderley Green, Stoke on Trent. The practice had not previously been inspected by CQC. In February 2017 the provider was successful in winning the contract to manage The Practice Drayton Road, located within Longton Health Centre which was previously managed by Chilvers & McCrea Limited. This became effective from 1 April 2017. The patient lists merged and the provider designated the Drayton Road practice as the main location and head office with the practice at Weston Road becoming a branch surgery. The two practices are less than one mile apart.

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

• Staff understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However, the provider had not had the opportunity to document all events identified as a result of taking over the main practice.
• Most risks to patients were assessed and managed
• There was a staffing structure in place and staff were aware of their own roles and responsibilities.
• The nurse practitioner had recently completed an independent prescriber course however; there was no formal system in place to support them in this extended role.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey for the former Adderley Green Practice showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. However, some patients shared concerns with us about the lack of confidentiality at the the reception desk at the main practice.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients reported considerable difficulty when trying to contact the practice by telephone and expressed dissatisfaction with the availability of appointments.
• 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 the management team. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Review and improve arrangements for making appointments.

• Consider obtaining an Automated External Defibrillator (AED) in the practice as recommended in the ‘Primary care – Quality Standards’ published by the Resuscitation Council UK or alternatively review the current risk assessment to ensure it is comprehensive and clearly details why an AED is not required.

• Implement a formal system to support the nurse practitioner in their extended role.

• Ensure all outstanding significant events are recorded and investigated.

• Consider reviewing the confidentiality arrangements at the main practice reception desk.

• Carry out a review of staffing to ensure there is sufficient clinical capacity to meet patient demand.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice