We carried out an announced comprehensive inspection at Beckett House Practice on 7 January 2016. Overall the practice is rated as Outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

• 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.

• Feedback from patients about their care was positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice was well equipped to treat patients and meet their needs. Information about how to complain was available in a variety of languages and was easy to understand.
• 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 several areas of outstanding practice including:

• The practice had translators who would attend the practice on set days each week to accommodate Portuguese and other foreign languages speakers. Twenty percent of the practice’s population were Portuguese speaking and 11% were Spanish speaking. Fifty percent of the Portuguese speaking population and 58 % of Spanish speakers required the use of a translator. The practice had developed its translation policy on the basis of feedback they had received from patients and had a range of information translated into other languages; including their complaint policy and chaperoning policy. The practice’s out of hours answer phone message had also been translated into three different languages.

• The practice had completed business cases in conjunction with two colleagues from other federations which resulted in funding being obtained for two initiatives which were introduced to other practices in the locality. Firstly the practice had helped to introduce Primary Care Navigators (non clinical staff trained to provide information and make referrals to support agencies that could help patients manage their long term conditions more effectively) within the locality. The practice’s Primary Care Navigator had referred 25 patients since July 2015 compared with no referrals between April and June 2015; prior to the introduction of the care navigator. The Primary Care Navigators within the practice are both Spanish and Portuguese speakers to ensure that people who speak these languages are able to access this service. The practice had also worked to obtain funding from the CCG to make the holistic health assessment programme viable for GPs in the locality and participated in a subsequent audit which showed a significant increase in the numbers of the assessments being conducted and ensured that funding was continued.

• The practice manager costed and setup a weekend winter hub at a neighbouring GP practice over the winter of 2014/15. This was staffed by receptionists from the practice who worked outside of their contracted hours. The hub enabled other providers in the locality, out of hours services and A &E services to divert patients where appropriate over the busy winter period. Work undertaken at the winter hub formed the basis of a successful bid to fund local extended hours access hubs under the Prime Minister’s challenge fund as those practices involved were able to demonstrate, through joint working, their ability to operationalise a service at short notice with limited resources.

The areas where the provider should make improvement are:

• The practice should ensure that all staff complete annual basic life support training.

• The practice should review the systems to ensure mediciens are fit for use.

• The practice should review their fire safety policy and consider fire safety training for all staff.

• The practice should consider instituting a programme of clinical audits.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice