Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gayton Road Health Centre on 17 January 2017. 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.
• 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.
• Feedback from patients about their care was positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice in line with others for most aspects of care.
• 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.
• 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 well 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 provider was recognised as “An Investor In People” (the Investing In People Standard explores practices and outcomes within an organisation under three performance headings: leading, supporting and improving).
• Although the provider maintained performance data and information for the organisation, a breakdown of individual practice’s Quality Outcome Framework performance was not available and could not be provided by the practice.
• An incident occurred several days prior to the inspection where a car had driven through the walls of the practice building causing significant damage to the premises back office area. Despite the considerable damage and need for amending the day to day operations the practice was able to operate as per usual and facilitate our inspection.

We saw several elements of outstanding practice:

• The practice made use of a ‘customer service charter’, which aimed to support all of the practice staff in delivering excellent customer service by following an agreed set of standards on timeliness, accuracy and appropriateness. There were four champions active at the practice and they met with champions from five other practices that the provider managed on a monthly basis to discuss complaints and commendations.
• The practice had developed the “ABC team”, which staff described as the connection between the practice and its elderly and less able patients. This team of nursing staff travelled to patients’ homes to assist patients in maintaining independence and to ensure that they had the physical and mental capacity to look after themselves.
• The practice had developed the “My Practice Passport” for patients with dementia and had been rolled out to other patient groups, for example patients with a visual impairment. The passport was a document that was kept on the patient and contained information about the patient stating “things you must know about me”, “things that are important to me” and “things I like and dislike”.

The area where the provider should make an improvement is:

• Improve the recording of meeting minutes and actions to provide evidence of decision making processes.
• Ensure policies and protocols are reviewed in a timely manner.
• Ensure recorded supervision of nurse practitioners by GPs takes place effectively.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice