Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (The previous inspection was carried out on 26 November 2015 and the practice was rated as Good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Grove House Surgery and the branch surgery at Chickenley Medical Centre on 10 January 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear, organised systems and protocols to review and manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice were honest and open, ensured that all staff learned from them and improved their processes.
• Regular meetings were held between the clinical team and the wider multidisciplinary team, including health visitors, midwifes and members of the palliative care team. Managers from the care homes which the practice supported were also invited.
• There was an embedded comprehensive system in place for actioning and cascading medicine safety alerts.
• Results from the July 2017 annual national GP patient survey showed that the patient experience of making an appointment was good. Patients also found it easy to get through to the surgery by phone and satisfaction was 16% higher than the national average.
• The practice had commenced a review of the immunisation status of the staff team; however, this had not been fully completed on the day of inspection. Following our visit a staff immunisation policy was implemented.
• The practice had a Patient Participation Group (PPG) with up to six regular members. The group told us they felt valued by the practice and suggestions, comments and criticisms were always acted upon.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice were participating in the Productive General Practice programme and had implemented new processes for workforce planning and workforce organisation. For example, the patient services team had implemented a ‘jobs board’ whereby each required daily task was allocated to an individual using a red and green card. We saw that roles, tasks and responsibilities were clear and managed in a timely manner.

The areas where the provider should make improvements are:

• The provider should continue to proactively identify patients who are carers to assure themselves that they are able to offer them the appropriate support.
• The provider should continue to review and document the immunisation status of the staff team.
• The provider should review the seating in the reception area of the Chickenley Medical Centre.

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 Grove House Surgery on 26 November 2015. 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.
• Emergency drugs and equipment were available however the arrangements for the management of emergency medicines had not been appropriately risk assessed.
• Risks to patients were assessed and well managed.

• 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 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.
• 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.

We saw one area of outstanding practice:

The practice had an innovative system in place to monitor and review patients with long term conditions, in particular diabetes. We saw evidence that the practice engaged strongly with other healthcare professionals and the wider community in education of diabetes and other long term conditions.

The areas where the provider should make improvements are:

• Have a process in place for undertaking criminal record checks at the appropriate level (only for staff who require a check) and assess the different responsibilities and activities of staff to determine if they are eligible for a DBS check and to what level.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice