Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Enfield Island Surgery on 20 July 2016. The overall rating for the practice was good, however the practice was rated as requires improvement for providing a safe service. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Enfield Island Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 26 September 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 20 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had a defibrillator in place. We saw evidence of a maintenance log to ensure that it was working and fit for purpose. All staff had received training and the use of the defibrillator had been included in the updated practice policy and procedure for dealing with emergencies.

• All staff had received a current Disclosure and Barring Service (DBS) check.

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

The provider should:

• Consider the installation of an induction loop.

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 Enfield Island Surgery on 20 July 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• Risks to patients were assessed and generally well managed; however, we found emergency medicines that were out of date and the practice did not have a working defibrillator.
• 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 generally 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 improvement are:

• Ensure all staff have a current Disclosure and Barring Service (DBS) certificate and where DBS checks are not completed, for risk assessment to be carried out to demonstrate how the risks of not having one will be mitigated.

The areas where the provider should make improvements are:

• Improve waiting times for patients attending GP appointments.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Enfield Island Surgery is a small surgery consisting of two General Practitioners (GP’s), a part time practice nurse, practice manager and reception staff. The surgery is located at Enfield Island Way and has a list size of 4200 patients of which 1800 are under the age of sixteen. The majority of patients are either young families or working age people.

We carried out an inspection on 28 May and on 30 May 2014. As part of the inspection we spoke to GP’s, the practice nurse, practice manager, reception staff and patients awaiting their appointment. We also received feedback through Care Quality Commission (CQC) feedback cards which were available for the public to complete prior to the visit.

We inspected the following CQC regulated activities, diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

The practice had systems to monitor safety and staff reported and learnt from incidents. Data from the Quality and Outcomes Framework (QOF) and the local Clinical Commissioning Group (CCG) was used to review and improve the practice performance.

The practice was well led with a clear leadership structure and open and transparent culture. Governance procedures were in place and feedback from patients and external data was used to monitor and improve the quality of service provided.

The practice had a Patient Participation Group (PPG) but attendace at meetings was low and the practice was reviewing the timing of meetings in order to improve attendance. Patients had mixed views about accessing appointments with some saying it was difficult to get an appointment. Another key issue was the length of time it took to make an appointment using the telephone and how long they were kept on hold. The practice was aware of this issue but said it was unable to install additional phone lines.

The practice was able to meet the needs of the different population groups who accessed the service. Many of whom are either working age or young families. It had a range of services with some GPs undertaking further training in specialist areas, for example care of older people and women during pregnancy and early identification of childhood illness.