This practice is rated as Good overall. (Previous rating Good -18 May 2016).

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Kensington Partnership on 18 July 2018. The inspection was undertaken as part of our inspection regime and in response to changes within the practice which incorporated a previous location, Mughal Medical Centre. Mughal Medical Centre was rated as requires improvement for providing safe and well led services at their last inspection on 14 March 2017.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice reviewed any issues at regular meetings, learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided except for in relation to circumcisions. Patient needs were discussed regularly within the team and with stakeholders. A clear strategy was in place.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The majority of patients found the appointment system easier to use, following the introduction of a new telephone system. Patients said they were able to access care when they needed it.
• The practice had a functioning patient participation group (PPG) which was integral to the running of the practice. The group reviewed comments, complaints, staffing needs and feedback. Meetings were held regularly and attended by a number of staff.

We saw areas of outstanding practice:

• The practice and the patient participation group (PPG) had undertaken a number of surveys in 2017 which individuals who were reflective of the patient population. A patient and carer survey was undertaken in relation to access and the practice had also surveyed 140 students at two local schools. The aim of these surveys was not just to question the students registered at the practice but to understand and enable the practice to respond to the experiences of young people in primary care. We saw that changes were made as a result of these surveys following a review of the results with the PPG.
• We saw that the strong leadership and vision of the practice was to ‘future proof’ services to meet complex patients’ needs in a highly deprived area. There was a unified focus and commitment to staff support and development. Leaders at the practice supported the learning and development of students and a large number of team members at all levels of study, offering opportunities outside their current roles. We were told that leaders were approachable and encouraging.

The areas where the provider must make improvements as they are in breach of regulations are:

• Care and treatment must be provided in a safe way for service users.

 The areas where the provider should make improvements are:

• Staff should continue to review and update the training of the staff team and ensure that it reflects the practice policy.
• The provider should continue to review access to the service and ensure that patients are able to access appointments in a way which meets their needs.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kensington Partnership on 18 May 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 well managed and supported by the computer systems used by the practice.

• 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 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 did not find easy to make an appointment with a named GP. Urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Reception staff were infrequently acting as chaperones without a Disclosure and Barring Service check (DBS). (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). As these staff were not DBS checked and there was no risk assessment in place for this, we were assured that this would stop from the day of our visit.
• There was a clear leadership structure and staff felt supported by management. The practice worked closely with the Patient Participation Group (PPG) and 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 practice had completed five out of six modules to gain accreditation and attain the Gold Standards Framework. The Gold Standards Framework is a systematic, evidence based approach to optimising care for all patients approaching the end of life.

We saw areas of outstanding practice:

The practice offered a level two diabetes clinics where patients could be commenced on insulin therapy without attending hospital. (Insulin is a drug used for diabetics which keeps blood sugar levels from getting too high or too low). This clinic was offered to patients from other surgeries.

We saw excellent use of the clinical computer system used by GP practices in the area. The practice had developed a number of clear and proactive protocols, templates and care plans which helped staff to care for patients in a timely manner and to keep people well and safe. This included a reception protocol developed by GPs at the practice which allowed reception staff to ensure that patients received the most appropriate care and treatment. This clinically led, risk based protocol would direct staff to ring for an ambulance if required, book appointments urgently or ask people to speak to the pharmacy depending on their age and symptoms.

A Polish and a Czech interpreter were available at the practice each day to assist patients who also had access to a benefits adviser one morning per week.

The areas where the provider should make improvement are

The practice should ensure that all staff receive an annual appraisal.

The practice must ensure that all staff who act as chaperones for patients have undergone a Disclosure and Barring Service check (DBS).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kensington Partnership on 18 July 2018. The overall rating for the practice at that time was good. However, the practice was rated as requires improvement for providing safe services. The full comprehensive report on the July 2018 inspection can be found by selecting the ‘all reports’ link for Kensington Partnership on our website at www.cqc.org.uk .

This inspection was an announced focused follow up inspection carried out on 14 December 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulations that we identified in our previous inspection on 18 July 2018. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and for providing safe services.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

• The practice had implemented clear systems, practices and processes to keep children undergoing circumcision safe and safeguarded from abuse. There were adequate systems to assess, monitor and manage risks to patient safety which were embedded into the team.

• The provider had considered safeguarding issues and had reviewed outcomes of the procedure to ensure that a high-quality service was maintained.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice