Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

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 recently retired and students – Good

People whose circumstances may make them vulnerable – Good

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

We carried out an announced comprehensive inspection at Heeley Green Surgery on 23 January 2018 as a new provider had registered with CQC to provide regulated activities from this location in September 2017.

At this inspection we found:

• The practice had conducted safety risk assessments and there were action plans in place to address any risks identified.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence -based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect and patient feedback was positive about the care they received.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Structures, processes and systems to support good governance and management were clearly set out, understood and effective.
• There was a clear leadership structure and staff told us they felt respected, supported and valued. They felt part of a team and were proud to work in the practice.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Follow the significant event analysis (SEA) policy when reporting incidents.
• Review how the clinical meetings are recorded to ensure all in attendance are on the record and review the structure of the notes to ensure all items discussed are captured.
• Review the shared drive on the practice computer system to ensure the latest policies are accessible to staff.
• Consider risk assessments in relation to the security of the premises.
• Consider confidentiality at the front desk with regard to patients approaching the desk on an individual basis.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice