Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Nightingale House Surgery on 13 July 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.
• 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:

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Nightingale House Surgery is a general practice (GP) surgery that operates from a single premises located in Edmonton, within the Enfield Clinical Commissioning Group (CCG) area. Enfield CCG is a membership organisation of 54 local GP practices and is responsible for commissioning health services for a population of around 310,000 people. Census data showed that 38.8% of the population belong to non-white minorities which is more than three times higher than the England average (12.3%). Other White (18.2%), Black African (9.0%) and Black Caribbean (5.0%) are the biggest minority groups in the Enfield area. The service is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder and / or injury. The practice currently has just under 6000 patients on its list.

We carried out an announced inspection on 05 June 2014. The inspection took place over one day and was led by a lead inspector and a GP. A practice manager and an expert by experience were also part of the inspection team.

All the patients we talked with were very happy with the care they received. We received 28 comment cards and almost all had very positive comments about the care and service provided by the surgery. We spoke with all the staff members available on the day of our visit. These included three GPs, the practice manager, three clinical nurses and five members of the reception and administration team.

The GP partners provided a visible leadership, and staff we spoke with told us they were very supportive of them. There was a strong focus on caring for patients and the provision of a patient-centred care.

Though we identified some areas for improvement, overall we found that the practice provided an effective and caring service which was safe, well-led and responsive to people’s needs. The various population groups including older people, people with long term conditions, mothers, babies, children and young people, the working age populations and those recently retired, people in vulnerable circumstances and people experiencing poor mental health received a care that was effective and caring and mostly safe, responsive and well-led.

We reviewed the information available to us about Nightingale House Surgery on 21 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.