Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bedminster Family Practice on 9 March 2016. The practice was rated as requiring improvement for providing safe, responsive and well-led services; and was rated as good for providing effective and caring services. As a result, the practice was given an overall rating of requires improvement. Following the inspection we issued two requirement notices. A notice was issued due to a breach of Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, relating to safe care and treatment; and a notice was issued due to a breach of Regulation 17 of The Health and Social Care Act (Regulated Activity) Regulations 2014, relating to good governance.

Within our last inspection report we reported that the provider must ensure that:

• A risk assessment process was in place so that all clinical staff employed on either a permanent basis or as locum GPs had had their employment history and qualifications verified by a GP Partner, and a record of this stored on file.
• There was an overarching health and safety policy with a defined list of procedures or risk assessments in place to wholly meet the needs of the practice.
• There was a system to ensure that complaints were satisfactorily handled and monitored, and learning led to improvements being made to prevent reoccurrence.
• Compliments were monitored effectively and good feedback shared with staff.
• Practice policies were reviewed and updated to reflect changes in regulations and guidance.

The full comprehensive report on 9 March 2016 inspection can be found by selecting the ‘all reports’ link for Bedminster Family Practice on our website at www.cqc.org.uk.

We undertook a focused follow-up inspection of the practice on 6 June 2017. The inspection was to confirm that the practice had implemented its action plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 9 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

There were key findings across all the areas we inspected during this follow-up inspection. We saw documentary evidence:

• The practice had revised its employment application form to ensure that all prospective applicants were required to declare a full employment history, and explain any gaps in employment.
• The practice had revised its risk assessment processes so that all clinical staff employed on either a permanent basis or as locum GPs had had their employment history and qualifications verified by a GP Partner, and a record of this stored on file.
• The practice employment checklist had been updated to reflect the full range of immunisations required for clinical staff.
• Of a written risk assessment for all staff, covering professional registration, previous employment references, evidence of a Disclosure and Barring Service (DBS) check, and measures to ensure patient safety if clinical staff were employed before this information had been received.
• The practice had an overarching health and safety policy in place which included risk assessments for legionella’s disease (Legionella is a term for a particular bacterium which can contaminate water systems in buildings), and for the use of a platform lift.
• The practice had reviewed its policy for the management of complaints; and had taken steps to monitor complimentary feedback from patients, and share this information with staff.

Following this inspection the practice was rated as good across all domains, which changed its overall rating to Good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bedminster Family Practice on 9 March 2016. Overall the practice is rated as requires improvement. The domains for safe, responsive and well led are rated as require improvement. Effective and caring were good.

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

• There was an effective system in place for reporting and recording significant events.
• Risks to patients to patients care and treatment needs were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.

• The practice was working with a local service to develop a ‘Rapid Assessment Clinic for Older People’, which would allow a same day to within a four working day assessment of their needs.

• The practice provided minor injuries clinics and could provide treatment for cuts, lacerations and injuries.

• 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 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.

The areas where the provider must make improvement are:

• Recruitment practices must meet the regulatory requirements and employment law.
• The provider must ensure all health and safety risks to patients are assessed and actions put in place to minimise those risks.
• Complaints made to the practice must be responded to and where needed changes are made to improve the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice