Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection at Lindum Medical Practice on 25 July 2016. This inspection was a follow-up to our inspection of 23 June 2015 when the practice was rated as ‘requires improvement’. The practice submitted an action plan detailing how they would meet the regulations governing providers of health and social care.

At our follow-up inspection, we found the practice had made improvements in the two domains previously rated as ‘requires improvement’ and 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.

• 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.

• 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 should make improvement are:

• Ensure all policies and procedures are reviewed and updated including the policy in relation to significant events.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

REQUIRES IMPROVEMENT

We carried out an announced comprehensive inspection at Lindum Medical Practice on 23 June 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to require improvement for providing safe and well led services. It also required improvement for providing services for all the population groups. It was good for providing an effective, caring and responsive service.

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.
• There was a clear system for reporting incidents, near misses or concerns but evidence of learning and communication to staff was limited.
• Risks to patients were assessed and well managed except for DBS for staff undertaking chaperone duties.
• Data showed patient outcomes were at or above average for the locality. The practice achieved 95.1% of the total QOF target in 2014, which was the same as the CCG average and 1.6% above the national average.
• Audits had been carried out but we saw limited evidence that audits were driving improvement in performance to improve patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 94% patients who responded to the January 2015 national patient survey said they had confidence and trust in the last GP they saw.
• Information about services and how to complain was available and easy to understand.
• The practice had open access clinics on a daily basis. However patients said that they sometimes had to wait a long time for non-urgent appointments.
• 91% of people who responded to the January 2015 national patient survey said they could get through easily to the surgery by phone compared to the CCG average of 78% and national average of 74%.
• The practice had a number of policies and procedures to govern activity. We found that the practice did not keep them in one place which made it difficult for staff to access them.

The areas where the provider must make improvements are:

• Ensure there is a robust system to manage and learn from significant events, near misses and complaints.
• Have a system in place to ensure audit cycles have been completed and actions identified are followed up and completed.
• Ensure actions from fire safety risk assessment have been carried out to ensure patient, staff and visitor safety whilst in the practice.
• Ensure DBS or risk assessment is undertaken for staff who act as a chaperone.
• Ensure patients’ medical records are stored securely at all times.

In addition the provider should:

• Improve the availability of non-urgent appointments.

• Ensure staff have appropriate policies and guidance to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice. Ensure staff know where to find the policies and only have one policy for each area
• Have cleaning schedules in place for each area of the practice. Review and do spot checks to ensure an appropriate standard of cleaning has taken place.
• Improve their screening uptake figures across all screening services.
• Have information available to patients and in all clinical rooms in regard to the availability of a chaperone.
• Have a system in place to ensure all staff have awareness of Mental Capacity Act 2005 and Gillick competencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice