Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Brookside Group Practice on 29 June 2016 found breaches of regulations relating to the safe delivery of services. The overall rating for the practice was good. Specifically, we found the practice to require improvement for provision of safe services. It was rated as good for providing caring, effective, responsive and well-led services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Brookside Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 28 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified in our previous inspection on 29 June 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. On the 28 March 2017 we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe services as well as the previous rating of good for effective, caring, responsive and well led services.

Our key findings were as follows:

• Issues with emergency medicine checks and stock had been addressed. This included ensuring that all emergency medicines required were in stock and that all medicines were in date and fit for purpose.
• All medicines and equipment was in date and fit for use.
• Blank prescription forms for use in printers and handwritten pads were handled in accordance with national guidance as these were securely stored and there were systems in place to monitor their use.
• Patient Specific Directions (PSD) were used appropriately and in accordance with national guidance.
• The practice had reviewed how they identify carers to ensure they can offer effective care and support (1.04% of the practice list); this was an improvement on the previous 0.87%.

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 Brookside Group Practice on 29 June 2016. Overall the practice is 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 except those relating to medicines management.
• 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.
• There were issues with two emergency medicines not being available. However, this was rectified on the day of inspection. There were out of date medicines found at the Chalfont site.
• 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.
• 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 improvements are:

• Ensure the proper and safe management of medicines.
• Ensure the process for checking availability and expiry date of medicines is consistent across all sites.
• Ensure staff are using patient specific directives (PSD) appropriately.
• Ensure that there continues to be a system in place to monitor the distribution of all blank prescription stationery.

The areas where the provider should make improvements are:

• The practice should review how they identify carers to ensure they can offer effective care and support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of our inspection to Brookside Group Practice we spoke with various staff members including GPs, nurses, the patient service team and the practice manager. After the inspection we contacted four patients.

Patients were satisfied with the care and treatment they received and told us they were treated with respect. Patients’ records contained up to date and relevant information. Care and treatment was planned to meet patients’ needs. One patient told us, ”I have been with them for 35 years and they are excellent.” Another told us, “I have every confidence in my doctor; she really knows what she is doing.”

Staff had completed training for the safeguarding of children and vulnerable adults. Staff we spoke with were able to describe the possible signs of abuse and knew who to contact if they had any concerns. Staff were aware of the practice whistle blowing policy and told us they would use it if necessary.

We reviewed the practice’s systems to support staff. We noted that staff received training, professional development, supervision and appraisal. Staff we spoke with told us they enjoyed working at the practice and felt supported.

We looked at the quality monitoring systems used within the practice. The practice completed regular audits and patient questionnaires. Accidents, complaints and significant events were discussed at team meetings. We saw evidence of learning from audits and monitoring, to improve the quality of the service.

We reviewed the information available to us about Brookside Group Practice on 29 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.