Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 1 October 2014 at Brook Green Medical Centre. At that inspection the practice was rated good overall, but as requires improvement for some aspects of providing safe services. The full comprehensive report on the 1 October 2014 inspection can be found by selecting the ‘all reports’ link for Brook Green Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 15 December 2016 to check that the practice had followed their plan to address the findings we had identified in our previous inspection on 1 October 2014. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice remains rated as good. Following the desk-top review we found the practice to be good for providing safe services.

Our key findings were as follows:

• Healthcare assistants, who acted as a chaperone, were trained and had received an enhanced Disclosure and Barring Service (DBS) check. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

• Clinical and non-clinical staff had undertaken safeguarding adult training relevant to their role.

• Systems and processes were in place to ensure the safe recruitment of staff.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Brook Green Medical Centre provides NHS primary care services to patients in the Hammersmith area of West London. The practice currently has approximately 12,400 patients on its list. We carried out an announced comprehensive inspection of the service on 1 October 2014.

We rated the practice as Good overall for the quality of its services. The practice was rated as Good for the effectiveness of its service, Good for being caring and as Good for being well-led. We rated the service as Requires Improvement for aspects of safety and as Outstanding for being responsive to the needs of its patients.

Our key findings were as follows:

• The practice had systems in place to manage risks associated with medicines management, staff recruitment, infection control, child protection and medical emergencies. However, not all staff were trained on adult safeguarding and some staff who were occasionally called upon to act as chaperones were unclear about the role.
• The practice understood the needs of the population and had developed the service and skills of the staff team to meet patients’ needs. We found that care for some long term conditions such as mental health and diabetes was being managed effectively in the community and was provided in partnership with other specialist services.
• Patient satisfaction scores were in line with local and national averages for the quality of care and better than average for access to appointments. Patients we spoke with were very positive about the practice and described it as excellent.
• The practice had worked hard to ensure that the patient reference group was representative in terms of ethnic diversity, age and employment status, for example, recruiting patients from a nursing home and trying to engage patients in vulnerable groups.

We saw several areas of outstanding practice including:

• The practice proactively engaged with a local homeless charity to provide care to homeless people who were not engaging with health or other formal services.
• The practice provided outstanding care for people with mental health problems, for example offering joint assessment with the psychiatric liaison worker. Staff members were carrying out research on personality disorder in primary care.
• The practice was innovative in engaging patients with long term conditions for example running an open event and the use of a volunteer expert patient to support patients with diabetes. The volunteer regularly attended the practice to talk with patients with diabetes and signpost them to other useful resources in the community.
• The practice was open about sharing feedback with staff and patients, for example posting anonymised patient comments and concerns and the practice response in the waiting area.

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

The provider should:

• ensure that all staff undertaking chaperone duties should understand the role and how to carry it out effectively.

• ensure that GPs and practice staff receive training on recognising abuse of vulnerable adults
• obtain and document evidence in relation to new employees’ previous employment record in line with the practice recruitment policy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice