We carried out an announced comprehensive inspection at Links Road Surgery on 11 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider should make improvements are:

• Improve the system for monitoring registration of nurses, staff training and appraisals.
• Continue to review and improve the systems for recording temperatures of fridges used to store vaccines.
• Review and improve the recording of shared learning to support continuous improvement.
• Review and improve the monitoring of adults considered to be at risk by the creation of formal registers.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Links Road Surgery on 27 July 2016. We found that the practice required improvement for the provision of safe and well led services because breaches of regulation were identified. The full comprehensive report on the 27 July 2016 inspection can be found by selecting the ‘all reports’ link Links Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 16 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 27 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good for providing safe and well led services and rated as good overall.

Our key findings were as follows:

• There were clear processes for reporting, recording, acting on and monitoring of significant events to ensure leesons were learnt.

• A programme of ongoing clinical audit had been implemented.

• Risk assessments had been completed.

• There were clear processes for the management of controlled drugs.

• There was improved governance and oversight of policies and procedures that governed activity including safeguarding, complaints, recruitement processes and infection prevention control.

• A patient participation group had been initiated.

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 Links Road Surgery on 27 July 2016. Overall the practice is rated as requires improvement.

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

• All patients had a named GP. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. We received many comments from patients on the personalised care and support received from the practice.
• 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.
• There was an open and transparent approach to safety and a system in place for reporting significant events, although we found the recording processes could be improved.
• Most risks to patients were assessed and well managed. However, some systems and processes to address risks were not implemented well enough to ensure patients and staff were kept safe. This included the arrangements for managing controlled drugs in GP’s bags, the security and tracking of blank prescription paper, completion of recruitment checks, and the completion of electrical and gas safety checks.
• 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 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. 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 that there are clear processes for reporting, recording, acting on and monitoring significant events, incidents and near misses to ensure that lessons are learnt.

• Ensure that all policies and procedures used to govern activity are regularly reviewed and up to date, including safeguarding arrangements. Improve policies and procedures to ensure the security and tracking of blank prescriptions at all times.

• Ensure that disposable curtains are dated and replaced every six months to comply with national infection control guidelines.

• Ensure that there are clear and defined arrangements in place to securely store, monitor and dispose of controlled drugs.

• Ensure that recruitment checks are completed, including obtaining references, as set out in the practice recruitment policy.

• Ensure risk assessments are completed including for electrical and gas safety.

• Develop an on-going clinical audit programme to show that continuous improvements have been made to patient care in a range of clinical areas as a result of audit.

• Ensure care plans are routinely completed and reviewed for all patients with a long term condition.

The areas where the provider should make improvement are:

• Continue to improve records and oversight of training to ensure all staff have completed their training requirements.
• Consider improvements to the recording of complaints to enhance efficiency and the management of the process.
• Ensure there are arrangements to provide regular communication and updates to all staff, including regarding senior management changes in light of succession planning.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Links Road Surgery is located in the Portslade area of Brighton and Hove. The practice occupies a house in a residential area and provides access for patients with a disability and those with pushchairs and young children. This was the first inspection since registration.

All the patients we spoke with gave positive feedback about the practice and staff. We reviewed the results of the last patient survey. This showed patients were consistently pleased with the service they received.

The practice had responded to safeguarding concerns and had robust processes and procedures to keep patients safe.

Staff told us the registered manager and practice manager were supportive and there was an open culture where staff felt able to approach them with concerns.