Letter from the Chief Inspector of General Practice

Dear Dr. Gurjinder Singh Randhawa

We carried out an announced inspection visit on 6 October 2014. The overall rating for the practice was good.

We found the practice to be good in providing: safe, effective care and for all of the population groups it serves. In addition we rated the practice as outstanding with respect to its responsiveness to patient’s needs.

Our key findings were as follows:

• Where incidents had been identified relating to safety, staff had been made aware of the outcome and action taken where appropriate, to keep people safe.
• All areas of the practice were visibly clean and where issues had been identified relating to infection control, action had been taken.
• People received care according to professional best practice clinical guidelines. The practice had regular information updates, which informed staff about new guidance to ensure they were up to date with best practice.
• The service ensured people received accessible, individual care, whilst respecting their needs and wishes.
• We found there were positive working relationships between staff and other healthcare professionals involved in the delivery of service.

We saw areas of outstanding practice including:

• Where an individual patient was anxious about sitting in the waiting room prior to an appointment, the reception staff text them at their appointment time. This allowed the person to go straight into the GP consultation room and was a response to their individual needs.

We also noted that improvements should be made in relation to the following:

• The practice nurse recorded weekly checks on emergency drugs (‘Drug Ledger’) and reordered more stock when it fell below a pre-determined account. However, when the nurse was on leave the stock levels were not recorded or monitored.
• The practice had an up to date recruitment policy. However, the recruitment files we inspected did not contain two references as stated in the policy.

Yours sincerely

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Patients attending the practice had access to a variety of information. The practice leaflet included information about the staff and services available. English, Urdu and Punjabi versions of the leaflet were available to download from the practice web site.

The practice continually monitored requests for appointments and adjusted availability to match the demand. A telephone triage system had been introduced to prioritise appointments and give patients the option of a telephone consultation with a doctor.

Consultations were holistic and where appropriate patients were signposted or referred to other agencies. Relevant patient medical history, examinations, diagnosis and treatment were fully documented. Treatment options were discussed and where appropriate written information was available to take away.

There were nominated leads for both child and adult safeguarding. Staff were confident that safeguarding concerns would be taken seriously by the practice. They were also aware of who to contact to report any concerns they had which were not being dealt with appropriately.

Staff received appropriate professional development. New staff at the practice received competency based induction training which was overseen by a senior member of staff. The induction included; patient contact, booking appointments and the use of the practice clinical system.

Patients who used the service were asked for their views about their care and treatment and they were acted on.

This practice is rated as Good overall. (A previous inspection undertaken on 6 October 2014 had rated the practice as Good overall.)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Beeston Village Surgery on 17 April 2018, as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. They ensured that care and treatment was delivered according to evidence- based guidelines and best practice.
• There was evidence of safe prescribing with regular reviews undertaken with those patients who were prescribed high risk medicines.
• The practice had reviewed access to appointments and had adapted clinics to support maximum provision of appointments for patients. They also participated in a local scheme which supported patients with mobility problems in getting to the practice.
• Patients’ comments were positive regarding access to appointments and the service they received from practice staff.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was evidence of a cohesive practice team. Support and respect was shown by all members of staff towards one another.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• There was a range of all-inclusive meetings to ensure all staff were engaged and kept up to date. This included a daily ‘team brief’ lead by the GP.

There is one area where the provider should make an improvement:

• Clearly record all actions undertaken in relation to patient safety alerts.

P

rofessor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice