Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Laurence Howard Sherman on 6 December 2016. Overall the practice is now rated as good.

The practice had been previously inspected on 19 May 2015. Following that inspection the practice was rated overall requires improvement with the following domain ratings:

Safe – Requires improvement

Effective – Good

Caring – Good

Responsive – Good

Well-led – Requires improvement

Two requirement notices were issued as the practice was not meeting the legislation in place at that time for the following:

• Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe care and treatment
• Regulation 13 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safeguarding service users from abuse and improper treatment.

Following this re-inspection on 6 December 2016, 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.

• 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.
• 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 should make improvements are:

• The practice should ensure they have access to a defibrillator on the premises and oxygen with adult and children’s masks. However at this inspection we saw evidence that the practice already had submitted plans to procure these items as a matter of urgency.

We saw one area of outstanding practice:

• The practice had achieved the best results for the uptake of seasonal influenza vaccine in the local Clinical Commissioning Group area for 2015/16. The GP not only delivered the programme in the surgery but also made numerous home visits to ensure that their eligible patient population had the opportunity to receive the vaccine in a timely manner.  As a result of this the GP was invited by Public Health Bury to attend the Seasonal Flu Group to share good practice with other colleagues. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Dr Laurence Howard Sherman on 19 May 2015. We found that the practice was rated as good for effective, responsive and caring, but requires improvement for safe and well-led giving an overall rating as requires improvement.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded and monitored but not always shared widely within the team.

• Data demonstrated patient outcomes were above average for the locality. We saw evidence that clinical audits were driving improvement in performance to improve patient outcomes.

• Risks to patients were assessed and managed, however there were no documented risk assessments in place.

• There were limited training records for staff and no documented plan in place for future training.

• 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.

• Urgent appointments were usually available on the day they were requested.

• The practice did not hold regular formal governance meetings but issues were discussed at ad hoc meetings. There were no records or minutes of any internal or external meetings.

The areas where the provider must make improvements are:

• Ensure all staff receive current training in safeguarding vulnerable adults and children for all staff and this is recorded.

• Ensure that documented risk assessments are in place to include those risks to patients, staff and the general environment, paying particular attention to fire safety and infection control.

In addition the provider should:

• Ensure all staff training is recorded, reviewed and planned, and a record of this maintained.

• Ensure there are formal governance arrangements in place and staff are aware how these operate.

• Ensure that there is a record of all meetings that take place both internal and external to the practice and actions from these meetings recorded.

• Ensure all staff have access to appropriate policies, procedures and guidance that are regularly reviewed and updated, to carry out their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Dr Laurence Howard Sherman on 8 June 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.