We carried out an announced comprehensive inspection of Killick Street Health Centre on 17 August 2017. We rated the practice as good for providing effective, caring, responsive and well-led services and the overall rating was good. We rated the practice as requires improvement for providing safe services, as we had concerns relating to infection prevention and control issues, safety checks and mandatory training for staff.

We served a requirement notice relating to the practice’s failure to comply with Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We also recommended two improvements the practice should make under the key questions of effective and well-led, as follows: Proceed with plans to improve how learning from clinical audits is passed on; Proceed with the planned schedule of reviewing governance protocols and policies.

The full comprehensive report on the August 2017 inspection can be found by selecting the ‘reports’ link for Killick Street Health Centre on our website at http://www.cqc.org.uk/location/1-572907531. After the inspection, the practice sent us a plan of actions it intended to take to ensure it was able to meet the legal requirements under the key question, Safe.

This inspection was a focussed inspection carried out as a desk-based review of evidence we requested from the practice in March 2018, looking at the issues previously identified and to check and confirm that the practice had carried out its plan to meet the legal requirements. We found that the practice had taken appropriate action to meet the requirements of the regulations relating to providing a safe service. Accordingly, we have revised the practice’s rating in respect of providing a safe service to good. The revision of the rating does not effect the ratings given after our previous inspection in August 2017 for the other key questions and the six population groups, which were rated good.

The practice also sent us evidence under the key questions of effective and well-led. We saw minutes of clinical meetings and presentations that confirmed the results and learning from a number of recent clinical audits had been reviewed and discussed. The practice sent us confirmation that the review programme of its governance protocols and policies had proceeded to plan.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

The practice was previously inspected in April 2015 and had been rated as good for all key questions, population groups and overall.

We carried out this announced comprehensive inspection of the Killick Street Health Centre on 17 August 2017. Overall the practice is rated as good and requires improvement for providing safe services.

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

• There was limited assurance about safety. Systems, processes and policies were not always reliable or appropriate to keep people safe. These included infection prevention and control issues, safety checks and mandatory training for staff.
• A number of governance policies and procedures were overdue review. However, we saw evidence that a planned review schedule was in place.
• The practice had carried out various clinical audits to improve patient outcomes, but learning from these was not consistently passed on to all staff.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Data from the Quality and Outcomes Framework showed patient outcomes were above local and national averages.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Staff were aware of current evidence based guidance.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The area where the practice must make improvement is:

• Ensure care and treatment is provided in a safe way to patients. For example, by providing appropriate refresher training to all staff in safeguarding and infection prevention and control; maintaining cleaning logs and records of safety checks.

The areas were the practice should make improvement are:

• Proceed with plans to improve how learning from clinical audits is passed on.
• Proceed with the planned schedule of reviewing governance protocols and policies.

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 Killick Street Health Centre on 15 April 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice