Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Devonshire Lodge Practice, Pinner, Middlesex, HA5 1TG on 1 March 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.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Patients when interviewed 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.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from patients and staff, which it acted on.

• The provider was aware of and complied with the requirements of the Duty of Candour.

The area where the provider should make an improvement is to:

• Implement a programme of continuous quality improvement to improve outcomes for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out this inspection following shortfalls we identified during our previous inspection on 26 November 2013. During our previous inspection we found inadequacies in the complaints system for the service. We asked the provider to make improvements and they wrote to us and told us the action they would take to address the shortfalls identified. At this inspection we found that improvements had been made.

This inspection was carried out as a result of concerns raised with the Care Quality Commission about the quality of care and treatment provided by the practice.

During our inspection we spoke with nine people using the service and eight staff including the practice manager, two GP's and a practice nurse. People told us they were happy with the care and treatment they received. One person said "the staff are good." Another said "I can usually get an appointment in a reasonable time, I am never waiting too long."

People were protected from the risk of abuse. Safeguarding procedures were in place for children and adults and staff were aware of them. They had also received adequate support and training to meet the needs of people using the service, including induction training for new staff, training to deal with foreseeable emergencies and training specific to their role. Appraisals had been completed to assess staff performance and identify any development needs.

Effective systems were in place to monitor the quality of service provided including satisfaction surveys, audits and risk assessments. The results of surveys and audits had been analysed and action taken to make improvements to the service where necessary. There was a complaints procedure in place and people were made aware of it. However, people's complaints were not always acknowledged until received in writing. Responses did not always fully address the complainants concerns and where complaints were substantiated the responses did not identify the remedial action that had been taken as a result to reduce the likelihood of reoccurrence. We also noted a lack of clinical input in complaints handling which meant that some responses did not always fully address people's complaints.