We carried out this announced comprehensive inspection of North Wood Group Practice on 2 May 2019. We had previously carried out an announced comprehensive inspection prior to the merger of two practices at the Crown Dale site on 27 March 2018. At that time the service was rated as good. It was rated as requires improvement for the responsive domains and good for all other key questions. All population groups were rated as good.

The area where we said that the provider must make improvement were:

• Ensure that systems and processes are in place to ensure safe care and treatment. This should include ensuring that appointments are accessible to patients.

At the inspection on 2 May 2019 we found that these areas had been addressed by the practice which is now rated as good in all areas.

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

We found that:

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

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

This practice is rated as Good overall. The practice was previously inspected by the CQC on 26 November 2014. At that inspection the rating for the practice was good overall. This rating applied to all five domains and all six population groups.

We carried out an announced comprehensive inspection at Crown Dale Medical Centre on 27 March 2018 This inspection was scheduled as part of CQCs ongoing inspection programme.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires Improvement

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

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 had implemented defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• 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 involved and treated patients with compassion, kindness, dignity and respect.

• Information about services and how to complain was available.

• Patients told us that they were not always able to make appointments at the practice. The national patient survey also showed that patients found it difficult to make appointments.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw two areas of outstanding practice:

• The service had piloted the local care co-ordination model for Lambeth CCG in 2017. This targeted patients with three or more long term conditions. This involved a person-centred care assessment and a health and wellbeing care plan. Thirty seven such assessments were completed in the last year.

• The service managed a borough wide diabetes service including diabetes clinic, Desmond educational events, virtual clinics and support to practices where diabetes management was of concern. The service had improved the number of patients attending structured education events from 800 in 2014/15 to 1,500 in 2016/17.

The areas where the provider must make improvements are:

• Ensure that systems and processes are in place to ensure safe care and treatment. This should include ensuring that appointments are accessible to patients.

The areas where the provider should make improvements are:

The practice should consider reviewing the level of exception reporting at the practice which is above the national average.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We reviewed the information available to us about North Wood Group Practice on 30 April 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.