Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lower Clapton Group Practice on 1 December, 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.
• 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.

We saw one area of outstanding practice:

The practice provided a frail home visiting (FHV) service visiting service where all housebound patients are visited a minimum of two visits per year, and an average of four visits per year is carried out across the whole house bound register. The purpose of this is to proactively identify physical, psychological and social needs so as to improve overall quality of life and reduce acute hospital attendances and admissions in this vulnerable group. There were 78 patients on the FHV register and over the last 12 months these proactive visits had resulted in in a total of 16 new clinical diagnoses.

The areas where the provider should make improvement are:

• Continue to take action to raise the level of patient satisfaction around contacting the practice by phone.

• Take action to ensure the complaints system is managed in a way that ensures complainants receive a written response in line with practice policy.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During our visit to the practice we spoke with four people who used the service which included the PPG lead person, a GP, the practice manager, the deputy manager, practice nurse and senior receptionist. People who used the service told us that the GP explained the treatment options. One person said, "the doctor will explain things and show me information on the computer."

People's privacy, dignity and independence were respected. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care

People we spoke with told us of their experience of the practice. People told us that the clinical staff took time to discuss and explain their care and treatment. All the patients we spoke with were happy with the service they received from the practice. One person told us, "the practice is consistently good. Good ethos, supportive, good facilities and there when you need them."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff received appropriate professional development. Patients told us they had confidence in the knowledge and skills of the GPs, the practice nurse and the other staff at the practice.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.