Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingswood Health Centre on 16 August 2016.

Overall the practice is rated as good, with the domain of responsive rated as outstanding.

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.
• 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; there was an active patient group.
• Information about services and how to complain was available and easy to understand; the practice website was very informative and easy to navigate, and received approximately 3000 visitors per month.
• Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said it was easy to make an appointment with a named GP and 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice were proactive in many areas of service development to improve access to treatment for patients; they were involved in an ophthalmology pilot which gave patients rapid access to assessment and treatment for a range of eye conditions.

We saw areas of outstanding practice:

• The practice worked collaboratively with a community based alcohol advisory service to provide community detoxification from alcohol for patients which allowed swifter access for patients who required this type of treatment.

• The practice employed a sexual health and contraceptive nurse who adjusted their working shifts according to when patientscould attend appointments. This was the only post of this kind in the area; the nurse also followed up those women whose circumstances make it imperative that they have adequate contraceptive advice for example, thoseat risk of sexual exploitation working as sex workers.

• The practice also supported the “interim beds pilot project” with South Gloucestershire Council in nursing and residential homes. These 20 beds were for patients (not necessarily registered with the practice) who were medically fit for discharge from hospital, but who needed a further period of rehabilitation or recovery before they returned home. The care the practice offered as part of the pilot included a weekly review, responsive care if patients became acutely unwell, and the management of their medicines as well as advice and support to the home staff team.

The areas where the provider should make improvement are:

The practice should ensure that the record of the emergency equipment detailed exactly what had been checked.

The practice should introduce a failsafe system which ensured all equipment was calibrated.

The practice should monitor the protocol for use of patients’ own medicines in the practice to ensure it is fully embedded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The Kingswood Health Centre was welcoming and friendly with courteous staff. A varied selection of information was displayed in the waiting room for the benefit of the patients. This included notices about the surgery and leaflets on health promotion and other support services.

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. The patients we spoke with provided positive feedback about their care. A patient said: "I am happy with the service I receive. I like it here”.

The staff members we spoke with told us they involved people in their own care and checked with people for their consent before treatment was given. People we spoke with also told us they felt safe to be treated by the staff at the Kingswood Health Centre.

Patients were cared for by suitably qualified, skilled and experienced staff because the provider had completed the relevant checks on staff before they started to work at the practice.

The provider had systems in place for monitoring the quality of service provision. There was an established system for regularly obtaining opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.