We carried out an announced comprehensive inspection at Maidstone Road Rainham Surgery on 10 December 2018 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 outstanding for all population groups.

We rated the practice as outstanding for providing responsive services because:

• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care, particularly for older people, people with long term conditions and families, children and young people.
• Learning from complaints recognised patients social and welfare, as well clinical, needs.

The practice had been rated as outstanding for caring at the last inspection in 2015. It was rated as good on this inspection because the factors that had caused it to be rated as outstanding for caring were now considered under the responsive domain.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• 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 way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The provider should:

• Improve the identification of carers to enable this group of patients to access the care and support they need.

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

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 the Maidstone Road Rainham Surgery on 4 December 2014. During the inspection we gathered information from a variety of sources. For example, we spoke with patients, interviewed staff of all levels and checked that the right systems and processes were in place.

Overall the practice is rated as good. This is because we found the practice to be good for providing services that are safe, effective, responsive, and well led. The practice is rated as outstanding for providing caring services. It was also good for providing services to families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed.
• Patients’ needs were assessed and their care was planned. Data showed that in the diagnosis and management of illness the patient outcomes were generally above average nationally and locally. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information to help patients understand the services available was easy to comprehend. Staff made special efforts to help patients who had particular needs to manage their appointments. Staff treated patients with kindness and respect, and maintained confidentiality.
• Patients said they found it easy to get through to the practice on the telephone. They were able make an appointment with a named GP and that 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. Information about how to complain was available and easy to understand.
• There was a leadership structure and staff felt supported by management. There was systematic clinical governance.

We saw some outstanding practice:

• The NHS national survey on patient satisfaction for the practice showed that patients were very satisfied with how they were treated. For example, the responses to the questions about GPs giving patients enough time, having trust in their GP and explaining tests were positive at 98%, 98% and 95% respectively.
• The patient survey information we reviewed showed patients responded positively to questions about their involvement in planning and making decisions about their care and treatment, and generally rated the practice well in these areas. For example, data from the national patient survey showed 94% of practice respondents said the GP involved them in care decisions.
• Patients, including vulnerable people and mothers with young babies were routinely telephoned at home, on the day of their appointments, either to be asked to come in earlier, as an appointment had become available, or to be asked to delay coming in because the appointments were running late.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice