We carried out an announced comprehensive inspection at Ilford Lane Surgery on 11 December 2017. The overall rating for the practice was good, with the exception of key question responsive which was rated requires improvement. The full comprehensive report on the December 2017 inspection can be found by selecting the ‘all reports’ link for Ilford Lane Surgery on our website at www.cqc.org.uk.

This inspection was a focused follow-up inspection carried out on 17 December 2018 to confirm that the practice had carried out their plan to meet requirements in relation to concerns we identified in our previous inspection on 11 December 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice remains rated as Good, with key question responsive remaining as Requires Improvement.

Our key findings were as follows:

• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had recruited a permanent practice nurse and had increased the number of sessions that the healthcare assistants provide to address patient demand for services at the practice.
• The practice obesity register was up-to-date and we saw evidence the practice reviewed patients in with this condition regularly. In addition, we found patients with asthma all had written care plans on their clinical record.
• There was a focus on continuous improvement at all levels of the organisation to provide quality services for patients.

The areas where the provider should make improvements are:

• Continue to monitor and address concerns highlighted by patients in the National GP Patient survey, with particular attention to scores relating to patient access to services and helpfulness of reception staff.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

The last inspection of this practice took place in December 2016. The overall rating for the practice at that time was good, with the exception of key question responsive which was rated as requires improvement. Our concerns at this time related to the insufficient numbers of suitably qualified, competent, skilled and experienced persons to meet patient demand as evidenced by the low patient satisfaction scores in the national GP patient survey. Following the December 2016 inspection, we issued the practice a regulation notice in respect of Regulation 18 of the Health and Social care Act (RA) Regulations 2014.

At this inspection we focused on the following key question which has been rated as:

Are services responsive? – Requires Improvement

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 with dementia) - Good

We carried out an announced focused inspection at Ilford Lane Surgery on 11 December 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 21 December 2016. This report covers our findings in relation to those requirements and also any additional improvements made since our last inspection.

At this inspection we found:

• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had recruited additional clinical staff to address patient demand for services provided at the practice.
• There was a focus on continuous improvement at all levels of the organisation in order to provide quality services for patients.

The areas where the provider should make improvements are:

• Consider the introduction of written care plans for patients diagnosed with Asthma. In addition, the obesity register should be kept relevant.
• Continue to monitor and address concerns highlighted by patients in the National GP Patient survey, with particular attention to scores relating to patient access to the practice.

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 Ilford Lane Surgery on 21 December 2016. Overall the practice is rated as good.

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

• The national GP patient survey found that patient satisfaction was below the local and national averages in several areas. The practice was aware of this and had taken action both before and shortly after our inspection.
• Not all patients who would benefit from a care plan had one recorded in their records, and where patients had care plans some of these had not been kept up to date.
• Not all patients with learning difficulties had received a formal annual review. Following our inspection the practice undertook annual reviews for this patient group.

• Clinical audits demonstrated quality improvement.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and managed, but there was an inconsistent approach to acting on medical updates and alerts. Following our inspection the practice introduced a robust system to ensure that all updates and alerts were acted upon.
• 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 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.
• 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 improvements are:

• Ensure that it continues to monitor and address the need to employ sufficient numbers of suitably qualified, competent, skilled and experienced persons to meet patient demand as evidenced by the low patient satisfaction scores in the national GP patient survey.

In addition it should:

• Continue to ensure that patients with learning difficulties receive a formal annual review.

• Consider preparing and displaying a mission statement so that staff and patients are aware of the practice’ overarching purpose.

• Ensure that all patients who would benefit from one have a care plan and that care plans are kept up to date.

• Continue to ensure that all significant events are fully recorded.

• Continue to ensure that safety alerts (such as medicines and medical device alerts) are dealt with in line with the practice protocol.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice