Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cricklewood GP Health Centre on the 17 January 2017. The overall rating for the practice was Good. The rating for the effective domain was requires improvement. The full comprehensive report on the 17 January 2017 inspection can be found by selecting the ‘all reports’ link for Cricklewood GP Health Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 8 November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 17 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• The practice had ensured that all staff had received basic life support, child protection, infection control, fire safety, mental capacity act and information governance training relevant to their role.

• The practice had now ensured that all staff had received an annual appraisal to enable them to carry out the duties that they are employed to perform.

• Since May 2017, patients have had online access to book appointments and order prescriptions.

At our previous inspection on 17 January 2017, we rated the practice as requires improvement for providing effective services as the practice had not ensured that all staff were appropriately trained and appraised in order to carry out the responsibilities of their role. At this inspection we found arrangements for both training and appraising staff were robust and effective, therefore ensuring that staff had the skills, knowledge and experience to deliver effective care and treatment. Consequently, the practice is rated as good for providing effective services.

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 Cricklewood GP Health Centre on 17 January 2017. This centre provides care for both registered and unregistered (walk-in) patients. Overall the service 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 a system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed; however some of the staff had not undertaken mandatory training.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• The service had a system in place for walk-in patients where reception staff followed prompts on the patient management system and identified any potential life threatening conditions or other conditions that required an urgent response; if any of these conditions were presented, the patient management system sent automatic notifications to clinicians and the reception team called for further assistance.
• Not all clinical and non-clinical staff had received regular appraisals.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The service 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 service proactively sought feedback from staff and patients, which it acted on; however the service did not have an active Patient Participation Group.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There were areas of service where the provider must make improvements:

• Ensure that all staff have safeguarding, basic life support, infection control, fire safety and information governance training relevant to their role.
• Ensure regular appraisals are undertaken for all staff.

There were areas of service where the provider should make improvements:

• Ensure that a failsafe thermometer is installed on the refrigerators that are used to store medicines.
• Review service procedures to ensure all patients with learning disability receive a regular health check.
• Review service procedures to ensure there is a system in place to support if families had suffered bereavement.
• Review service procedures to ensure patients are provided with online access for booking appointments and ordering prescriptions.
• Review how patients with caring responsibilities are identified to ensure information, advice and support can be made available to them.
• Review service processes for encouraging the uptake of cervical screening to ensure as many patients as possible participate.
• Ensure that a Patient Participation Group is established.
• Review the national GP patient survey results and address low scoring areas to improve patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We read comments from patient surveys, which were mostly positive and we spoke with a patient who was happy with the care and treatment received. One comment from a survey read, “a very smooth and professional service that is delivered with kindness and empathy” and another read, “an excellent service, the receptionist was very polite and helpful”. One patient told us, “reception staff are very polite and kind”. We observed staff respected patients in the manner they talked and interacted with them.

We saw from care records that the provider’s system for assessments ensured clinical risk was reduced for registered and walk-in patients, which meant patients experienced safe and appropriate treatment.

The provider had some arrangements in place, by way of relevant policies, staff training and Criminal Record Checks (CRB) to ensure patients were protected from abuse or risk of abuse. We observed that the provider ensured staff were trained and appraised, which meant they received appropriate professional development.

The provider had an effective system to regularly assess and monitor the quality of service that patients received