Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 22 June 2016. During our inspection we found a breach of legal requirements relating to systems and processes around recruitment of staff. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements set out in Regulation 19 of the Health and Social Care Act (Regulated Activities) Regulations 2014 Fit and proper persons employed.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements and should be read in conjunction with the full report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dr Nicholas & Partners on our website at www.cqc.org.uk

We found the practice had made improvements since our last inspection on 22 June 2016 and they were meeting the regulation relating to the recruitment of staff that had previously been breached. Specifically the practice was operating safe systems in relation to recruitment. This included:

• Ensuring clinical staff who had not had a Disclosure and Barring Service (DBS) check have now had this completed. (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)
• Reviewing policies relating to recruitment and implementing a checklist to ensure all appropriate checks are carried out prior to new staff starting employment with the practice.

In addition, the practice now ensures the security of prescriptions forms held in printers in consulting and treatment rooms. The provider have fitted locks on printers.

We have changed the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

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 Dr Nicholas & Partners on 22 June 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.
• Although risks to patients who used services were assessed, the systems and processes to address these risks were not implemented well enough to ensure patients were kept safe.
• 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.
• Most 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 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 areas where the provider must make improvement are:

• Ensure all staff have appropriate pre-employment checks prior to starting employment.

The areas where the provider should make improvement are:

• Ensure the security of prescriptions forms in printers are reviewed and addressed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating September 2016 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

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 Leckhampton Surgery on 18 July 2018 as part of our inspection programme.

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 learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Most patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice actively reviewed the waiting times for routine appointments and implemented a contingency plan where they either added additional appointments at the end of each GP sessions or added another GP session, when patients had to wait for more than three and half days
• There was a focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Take action to implement and embed a detailed infection control policy that includes regular audits.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.