We carried out an announced comprehensive inspection at Brigstock Family Practice on 26 March 2019. We inspected to check if the practice had improved telephone and appointment access since we inspected on 13 January 2017, when the practice was rated as good, but requires improvement for responsive.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way. The practice had taken action to improve telephone access and appointment availability and there was some evidence that patient satisfaction had improved.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Review systems for recruitment checks and complaints to ensure they are operating as intended.
• Review and take action to improve performance that is out of line with average/targets: exception rates for diabetes performance indicators, take up of childhood immunisation and cancer indicators.
• Continue to monitor and take action to improve patient satisfaction with telephone access and appointment availability.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brigstock Family Practice on 13 January 2017. The practice was previously inspected on 16 October 2014 and was rated as requires improvement for safe and well led leading to the practice being rated as requires improvement overall. Requirement notices were issued in respect of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, specifically regulation 21 Requirements relating to workers, regulation 15 suitability of premises and regulation 12 cleanliness and infection control.

The concerns identified which amounted to breaches of these regulations were:

• Reception staff did not have access to gloves and spillage kits to enable them to safely clean up any spillages of bodily fluids.

• Appropriate recruitment checks had not been completed for all staff before they started working at the practice.

• The practice did not undertake period fire alarm testing or have the fire alarm serviced regularly.

In addition to the breaches of regulation we also found that:

• The practice did not have a chaperone policy

• The practice’s defibrillator and oxygen supply were not being frequently checked to ensure that they were functional.

• The practice did not have a copy of London child protection procedures.

The report from our previous comprehensive inspection undertaken on the 16 October 2014 inspection can be found by selecting the ‘all reports’ link for Brigstock Family Practice on our website at www.cqc.org.uk.

This inspection was undertaken to establish whether or not the practice had made sufficient

Improvement since our last inspection. Overall the practice is now rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• There was now a system for storing prescription pads securely and reception staff were provided with gloves and spill packs. Recruitment checks now included obtaining references and a Disclosure and Barring Scheme check before clinical and non-clinical staff started work.
• 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.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• Data showed patients did not find it easy to make an appointment with a named GP or get through on the phone.
• 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 provider was aware of and complied with the requirements of the duty of candour.

• The practice had implemented an overarching governance framework to support the delivery of the strategy and good quality care.

The areas where the provider should make improvements are:

• To complete checks of oxygen when the responsible staff are absent.

• Continue to work to improve patient satisfaction with services as highlighted in the outcomes of the GP Patient Survey data.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Brigstock Family Practice provides a GP service to 4,100 patients in the Thornton Heath area of Croydon.

We carried out an announced comprehensive inspection on 16 October 2014. The inspection took place over one day and was undertaken by a lead inspector and a GP specialist advisor.

Overall the practice is rated as requires improvement.

Our key findings were as follows:

• We found the practice was caring. Patients told us staff respected their privacy and dignity, the services provided were suitable and they received the care and treatment they needed. They said the doctor gave them the time they needed, listened to their concerns and explained things to them in ways they understood.
• We found the practice was effective. Patients were assessed and treatments were in line with local and national guidance. Staff received the training and support they needed to carry out their role and the practice worked with other health and social care providers to ensure joined up care and treatment.
• We found the practice was responsive. There was a range of bookable and emergency appointments and patients could book appointments on line, by phone and in person. Suitable arrangements were in place for repeat prescriptions and patients said these worked for them. The practice had a Patient Participation Group which met regularly and carried out a survey to seek patients views on the services provided. The practice had responded to patient suggestions by increasing their opening hours and providing extended hours and nurse appointments.

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

Importantly, the provider must:

• Ensure prescription pads are stored securely when in use to be in line with current guidelines;
• Provide reception staff with gloves and spill packs;
• Ensure recruitment checks include obtaining references and a Disclosure and Barring Scheme check before clinical staff start work and
• Ensure the fire alarm system is tested weekly and serviced annually.

In addition the provider should:

• Develop a chaperone policy;
• Update the equipment checks to include pads for the defibrillator and oxygen pipe and
• Get a copy of the London child protection procedures.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice