This practice is rated as Good overall. (Previous rating 24 April 2018 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Not inspected on this occasion

Are services caring? – Not inspected on this occasion

Are services responsive? – Not inspected on this occasion

Are services well-led? - Not inspected on this occasion

We carried out an announced comprehensive inspection at Arlington Road Medical Practice on 01 and 02 March 2018. The overall rating for the practice was good. The practice was also rated good for the effective, caring, responsive and well-led domains and all the population groups. It was however rated as requires improvement for providing safe services. The full comprehensive report on the March 2018 inspection can be found by selecting the ‘all reports’ link for Arlington Road Medical Practice on our website at www.cqc.org.uk.

After the inspection in January 2018 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

At this inspection our key findings were:

• The practice had carried out and completed a comprehensive infection control audit.

• A five yearly electrical safety check had been completed.

• A general health and safety risk assessment had been completed.

Additionally, we saw that:

• All staff appraisals had been completed and new induction procedures implemented.

• The practice had improved systems and processes for the identification of carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Arlington Road Medical Practice on 2 December 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, responsive, caring and well led services. However it was rated as requires improvement in relation to providing safe services. The practice was rated as good for providing services to people with long term conditions, families, children and young people, working age people, people whose circumstances make them vulnerable and for services for people with mental health problems including those with dementia.

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

• The practice had a system in place for reporting, recording and monitoring significant events, incidents and accidents. There was evidence that the practice had learned from these and that the findings were shared with relevant staff.
• Patient feedback was overwhelmingly positive. Patients said they were treated with compassion, dignity and respect. They said they felt listened to and that they were involved in decisions about their care and treatment.
• Systems were in place to ensure high standards of cleanliness and infection control and patients said the practice was always clean and tidy.
• The practice provided additional services to its own patients and those from other practices over and above routine GP services, which included community dermatology and ear micro suction.
• The practice had implemented innovative approaches to improving services to patients. For example, by designating one single GP to undertake all home visits during the day, the practice had been able to extended appointment times for patients to 15 minutes. This gave patients more time and allowed GPs to undertake checks for long term conditions opportunistically. Also, as a result of being able to start home visits earlier in the day, inappropriate calls to the paramedics and hospital admissions had been avoided.
• There was a strong philosophy of investment in its services to improve patient care. The practice had recently invested its own funds to refurbish the practice premises and build and on site pharmacy. As a result the premises provided a modern, well equipped facility for patients and staff.
• The practice pro-actively identified and managed patients with dementia. The practice had a high diagnosis rate and had been better able to support these patients with their health needs and help them make decisions about their future care, including end of life planning.

However, there were also areas of practice where the provider needs to make improvements.

Specifically, the provider must:

• Carry out a formal risk assessment for using medical chaperones who had not received a criminal record check undertaken with the Disclosure and Barring Service (DBS).

In addition the provider should:

• Put arrangements in place to ensure significant events, performance, quality and risks are regularly discussed at practice meetings and that minutes are kept.
• Ensure all staff have an annual appraisal which is agreed and documented.
• Clarify the leadership structure so that lead roles and responsibilities are clearly identifiable.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection published 10 October 2015 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Arlington Road Medical Practice on 01 and 02 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to record, investigate, manage and learn from significant events and complaints.

• There were risk assessments completed in relation to safety issues however some were incomplete or overdue and the infection control audit was incomplete and required further work.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• The practice had introduced  a system that provided a dedicated visiting team of a GP and paramedic practitioner that could respond to visit requests, where appropriate, throughout the day

• The practice took account of staff and patient views and made improvements in response to them.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• The practice was a training practice and trained clinical staff from a variety of disciplines.

The areas where the provider must make improvements as they are in breach of regulations are:

Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

Complete the current round of staff appraisals and ensure that all induction activity is recorded.

Investigate and, where appropriate, introduce systems and processes to improve the identification of patients who have carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice