We carried out an announced comprehensive inspection at Kensington Street Surgery Practice on 3 May 2017. The overall rating for the practice was good. However, a breach of regulations was found which resulted in the practice being rated as requires improvement for providing safe services. The full comprehensive report for the May 2017 inspection can be found by selecting the ‘all reports’ link for Kensington Street Surgery Practice on our website at www.cqc.org.uk.

In addition to the breach of regulation, at the inspection on 3 May 2017 we also said the practice should consider the following areas:

• Continue to improve the identification of carers on the practice register to assure themselves that carers are aware of support available to them.
• Be able to assure themselves that cleaning schedules are in place for multi-patient use clinical equipment.
• Review the arrangements for checking medical supplies at the practice are in date.
• Continue to address issues identified in the national GP survey in order to improve patient satisfaction around accessing the practice.

This inspection was an announced focused inspection carried out on 18 April 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 at our previous inspection on 3 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

At this inspection we found:

• The practice had clear systems and processes in place to manage temperature sensitive medicines.
• The practice and patient engagement lead had improved the number of carers identified at the practice and liaised with the voluntary sector to continue to identify carers. A carers’ resource offered additional support by attending the practice to hold carers events. The number of carers identified by the practice had increased but remained at just less than 1%. A carer identification protocol has been implemented.
• The practice had implemented cleaning schedules for multi-patient use clinical equipment.
• The practice reviewed the stock of medical supplies monthly to ensure they were in date and recorded this.
• The practice was using innovative methods to encourage patients to respond to the GP patient survey and had made a number of changes to improve patient satisfaction. Actions taken included PPG involvement and community engagement events to increase satisfaction with the overall experience of the surgery. Seven day a week access to a GP as part of extended hour’s access via federation membership was available. In addition patients were encouraged to complete the GP patient survey online where it could be translated into a number of different languages. An iPad supplied by the federation was also used to show visual representations of the human body to patients; with the intention of improving patients’ involvement in their consultation, and aiding communication and understanding. GP patient survey results from 2017 showed an overall improvement from 2016. For example, 100% of patients said they had confidence and trust in the last nurse they saw or spoke to.

The areas where the provider should make improvements are:

• Continue to improve further the identification of carers on the practice register to assure themselves that carers are aware of support available to them.

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 Street Surgery Practice on 3 May 2017. Overall the practice is rated as good.

Specifically, we found the practice to require improvement for providing safe services. It was good for providing effective, responsive, caring and well led services. The population groups are rated as good for the patients using the practice.

• Where incidents had been identified relating to safety, staff had been made aware of the outcome and action was taken where appropriate, to keep people safe.
• All areas of the practice were visibly clean and where issues had been identified relating to infection control, action had been taken.
• Patients received care according to professional best practice clinical guidelines. The practice had regular information updates, which informed staff about new guidance to ensure they were up to date with best practice. The service ensured patients received accessible, individualised care, whilst respecting their needs and wishes.
• We found there were positive working relationships between staff and other healthcare professionals involved in the delivery of service. For example, the patients could access support groups such as carers resource, the local community centre volunteer services, my wellbeing college and the community mental health team, without being referred by the practice.
• Evidence we reviewed demonstrated patients were satisfied with how they were treated and this was with compassion, dignity and respect. It also demonstrated the GPs were good at listening to patients and gave them enough time.
• The provider was aware of and complied with the requirements of the duty of candour and had a clear policy statement. In addition, a policy called Being Open underpinned their approach to honesty and integrity, ensuring that all staff were aware of their duty of care.
• The practice had invested in an effectively designed visual environment, with the appropriate use of colour and lighting. The colour coding of patient appointment cards, messaging boards and clinical rooms creates a pleasant atmosphere for patients, staff and visitors and enabled those who could not read English to identify the correct consultation room and practitioner.

The area where the provider must make improvements is:

• Systems and processes must be established and operated effectively in order to be able to demonstrate good governance. The systems and processes for recording, reporting and responding to occasions when the refrigerator(s) used to store temperature sensitive medicines were reading outside of the accepted safe range of temperatures were not effective.

The areas where the provider should make improvement are:

• Continue to improve the identification of carers on the practice register to assure themselves that carers are aware of support available to them.
• The practice should be able to assure themselves that cleaning schedules are in place for multi-patient use clinical equipment.
• Review the arrangements for checking medical supplies at the practice are in date. For example we saw evidence of out of date blood glucose testing strips, swabs and blood sample storage bottles.
• Continue to address issues identified in the national GP survey in order to improve patient satisfaction around accessing the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice