Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. The practice was previously inspected on 23 July 2015 and rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at North Kensington Medical Centre on 23 November 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff had the skills, knowledge and experience to carry out their roles.
• Staff involved and treated patients with compassion, kindness, dignity and respect. The annual GP patient survey was above average for its satisfaction scores on consultations with GPs.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a leadership structure and staff felt supported by the management team and GP partners.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Consider the infection control lead undertaking enhanced training to support them in this extended role.
• Maintain up-to-date records relating to facilities management undertaken by NHS Property Services (NHSPS), specifically remedial work identified from risk assessments, to satisfy the practice that all areas managed by NHSPS are compliant.
• Review the NICE Guidelines NG51: Sepsis Recognition, Diagnosis and Early Management to ensure the practice can appropriately assess all patients, including children, with suspected sepsis.
• Consider the guidance of Public Health England’s ordering, storing and handling vaccines (March 2014).
• Consider how patients with a hearing impairment would access the service.

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 23 July 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Systems were in place for the recording and investigation of significant events and incidents. Staff were aware of their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well-managed, including managing medicines and infection control. The practice had safeguarding vulnerable adults and child protection policies and staff were up to date with child protection training.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and clinical staff had annual appraisals to identify any further training needs.

• Patients said they found staff to be pleasant, helpful, kind, courteous, friendly and that they treated them with dignity and respect. They were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients were satisfied with the appointment system and said they found it easy to make an appointment with a named GP and that there was continuity of care. Urgent appointments were available the same day of request.
• There was a clear leadership structure and staff felt supported by the GP partners. The practice proactively sought feedback from patients through surveys, Patient Participation Group (PPG) and suggestions and they acted on feedback to improve care and services.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should;

• Ensure that up to date safeguarding contact details are easily available to regular and locum staff.
• Ensure all staff receive up to date safeguarding vulnerable adult training.
• Ensure clinical staff receive Mental Capacity Act (2005) awareness training.
• Ensure information displayed in the waiting room is up to date and easy to read. This should include signs to notify patients of chaperone and translation services available.
• Conduct independent clinical audits in addition to CCG audit requirements.
• Ensure integrated care plans are formally agreed with patients and regularly reviewed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice