Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Knebworth and Marymead Practice on 8 November 2017. 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 with the exception of some infection control procedures. Infection control audits had been completed however, we noted there was a carpet on the floor of the treatment room used for taking blood samples. There were cleaning schedules in place but no checks were made by the practice to ensure standards were met. We found some areas of visible dirt and dust in one of the consulting rooms and in the cleaning buckets.
• 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.
• Clinical audits demonstrated quality improvement. There had been five clinical audits undertaken in the last two years, three of these were completed audits where the improvements made were implemented and monitored.
• Patients we spoke with were satisfied with the care they received and thought staff were professional and caring and treated them with dignity and respect.
• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice facilities were equipped to treat patients and meet their needs. There were facilities suitable for patients with disabilities that included access enabled toilets, wide doors and corridors and consultation rooms on the ground floor.
• 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 area where the provider must make improvement is:

• Ensure appropriate management of infection prevention and control to ensure standards are consistently met.

The areas where the provider should make improvement is:

• Carry out regular fire drills.
• Continue to monitor and ensure improvement to patient survey results for example in relation to overall experience and opening hours.

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 focused inspection at Knebworth and Marymead Medical Practice on 23 August 2017. This was to check that improvements had been made following the breach of legal requirement we identified from our comprehensive inspection carried out on 8 November 2016. During our inspection in November 2016 we identified a regulatory breach in relation to;

• Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014

- safe care and treatment.

This report only covers our findings in relation to the area requiring improvement as identified on inspection in November 2016. You can read the report from this comprehensive inspection, by selecting the 'all reports' link for Knebworth and Marymead Medical Practice on our website at www.cqc.org.uk.

The area identified as requiring improvement during our inspection in November 2016 was as follows:

• Ensure appropriate management of infection prevention and control to ensure standards are consistently met.

In addition, the practice were told they should:

• Carry out regular fire drills.
• Continue to monitor and ensure improvement to patient survey results for example in relation to overall experience and opening hours.

Our focused inspection on 23 August 2017 showed that improvements had been made. The practice is now rated as good for providing safe services. Our key findings across the areas we inspected were as follows:

• The practice had taken steps to ensure infection prevention and control met the required standards. Systems and processes had been improved and the infection control lead kept up-to-date with best practice.
• The practice were now following their fire safety protocol and held fire drills on a six monthly basis. We saw evidence to confirm a fire drill had taken place at both premises in March 2017.
• Staff worked closely with the patient participation group and the practice regularly reviewed and discussed their patient survey results. The practice had an action plan in place and had increased their clinical capacity, reviewed their appointment booking system and had made improvements to their telephone system. The latest National GP Patient Survey results published in July 2017 showed the practice had improved in several areas. For example, 79% of patients described the overall experience of this GP practice as good compared to the local average of 81% and national average of 85%. This was an increase of 14% when compared to the National GP Patient Survey results published in July 2016. 72% of patients were satisfied with the practice’s opening hours compared to the local average of 72% and the national average of 76%. This was an increase of 10% when compared to the National GP Patient Survey results published in July 2016.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice