Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Shutkever, Meulendijk, Soar & Brownlow on 15 September 2105. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 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.

We saw one area of outstanding practice:

• We saw one area of outstanding responsive practice. Practice nurses with a specialist interest in diabetes kept two 20 minute appointments each day available to book patients into with long term conditions to manage changes to their condition and also to offer support and education. Every six weeks a diabetes consultant or diabetes specialist nurse from the hospital visited the practice to jointly see patients with the practice nurses or provide them with supervision or discuss new guidelines. Patients we spoke with said this service was marvellous as they could be seen at the practice rather than going to the hospital and had confidence they were on the most up to date treatment regimes for their diabetes.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Register to use the National Reporting and Learning System (NRLS) eForm to report patient safety incidents.
• Ensure fire evacuation drills are performed to comply with fire safety regulations.
• Ensure all patients have the opportunity to contribute to their annual medication review

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out an announced focused inspection at Drs Meulendijk Soar & Brownlow on 15 January 2019 as part of our inspection programme.

At the last inspection in May 2018 we rated the practice as good overall, with a rating of requires improvement for providing safe services. The full comprehensive report regarding the May 2018 inspection can be found by selecting the ‘all reports’ link for Drs Meulendijk Soar & Brownlow on our website at .

The practice was rated as requires improvement for providing safe services because:

• A systematic and documented health and safety risk assessment which covered the operation of the practice had not been carried out.
• The significant event process showed some inconsistencies.
• There was limited assurance with regard to the effectiveness of management of the infection control audit process.

In addition to the areas for improvement identified under the key question of providing safe services, at the inspection in May 2018 we also said the practice should consider improving the following area:

• Review and improve the process of recording complaints, to include written and verbal complaints, in order to enable and improve the identification of any trends and learning from complaints within the practice.

At this inspection, we found that the provider had satisfactorily addressed these areas.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider and other organisations.

Overall the practice is rated as good overall, with the practice rated as good for providing safe services.

Our key findings were as follows:

• The practice had adopted a suite of health and safety risk assessments which had been embedded within the practice. In addition the practice had developed ‘ad hoc’ risk assessments which covered specific operations such as the installation of new public toilets.
• The practice had reviewed and updated their procedures with regard to the identification of significant events and had put in place measures to ensure that these were actioned and that learning from these incidents and events were shared with others.
• Issues identified in relation to the last infection prevention and control audit had been actioned. This included upgrades to the public toilets.
• The practice had begun to formally record both written and verbal complaints and from these were able to seek to identify any trends or themes.

There was one area where the provider should make improvement:

• Review and improve assurance in respect to confirming the immunity status of appropriate staff in relation to measles, mumps and rubella, and chickenpox.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.