Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Old Road Medical Practice on 04 June 2015. The overall rating for the practice was good; however, they were rated good for safe, caring, responsive and well-led services and requires improvement for effective services. The full comprehensive report on the June 2015 inspection can be found by selecting the ‘all reports’ link for Old Road Surgery on our website at www.cqc.org.uk.

We carried out an announced comprehensive follow-up inspection at Old Road Surgery on 05 May 2017. Overall, the practice is rated as good.

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

• Staff members knew how to raise concerns, and report safety incidents.
• Safety information was appropriately recorded; learning was identified and shared with all staff members.
• The infection control policy met current guidance. Audits had been carried out, reviewed, and analysed to monitor infection control.
• Risks to patients and staff members had been assessed, documented and acted on appropriately.
• Staff members assessed and delivered patient care in line with current evidence based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and involved in their care and treatment decisions.
• Information about the practice services and how to complain was readily available in English and Polish at the reception desk and the practice website in easy to understand formats.
• The practice was aware of and complied with the requirements of the duty of candour when dealing with complaints and significant events.
• Patients said they were able to make an appointment with a named GP and they received continuity of care. We were also told they had access to urgent appointments on the day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and in addition, staff members felt supported by the GPs and practice management team.
• The practice patient participation Group (PPG) worked proactively with the practice.

The areas where the provider should make improvements are:

• Audits undertaken should be completed cycles, to measure improvement.
• Identify areas of lower patient satisfaction within the GP survey to act on patient satisfaction improvement.

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 Old Road Medical Practice on 04 June 2015. The overall rating for the practice was good; however, they were rated good for safe, caring, responsive and well-led services and requires improvement for effective services. The full comprehensive report on the June 2015 inspection can be found by selecting the ‘all reports’ link for Old Road Surgery on our website at www.cqc.org.uk.

We carried out an announced comprehensive follow-up inspection at Old Road Surgery on 05 May 2017. Overall, the practice is rated as good.

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

• Staff members knew how to raise concerns, and report safety incidents.
• Safety information was appropriately recorded; learning was identified and shared with all staff members.
• The infection control policy met current guidance. Audits had been carried out, reviewed, and analysed to monitor infection control.
• Risks to patients and staff members had been assessed, documented and acted on appropriately.
• Staff members assessed and delivered patient care in line with current evidence based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and involved in their care and treatment decisions.
• Information about the practice services and how to complain was readily available in English and Polish at the reception desk and the practice website in easy to understand formats.
• The practice was aware of and complied with the requirements of the duty of candour when dealing with complaints and significant events.
• Patients said they were able to make an appointment with a named GP and they received continuity of care. We were also told they had access to urgent appointments on the day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and in addition, staff members felt supported by the GPs and practice management team.
• The practice patient participation Group (PPG) worked proactively with the practice.

The areas where the provider should make improvements are:

• Audits undertaken should be completed cycles, to measure improvement.
• Identify areas of lower patient satisfaction within the GP survey to act on patient satisfaction improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Following our inspection on 16 December 2013, we had concerns regarding the arrangements to ensure the privacy and dignity of people who used the surgery. In addition, we were not assured that staff knew how to report allegations of abuse and we found that paper medical records and confidential information which related to the people who used the surgery were not stored securely.

During our inspection on 10 April 2014, we found improvements had been made.

We saw that a privacy screen and a ‘vacant or engaged’ door sign were used to ensure the privacy and dignity of people who had an intimate examination or received treatment. We spoke with three people who used the surgery, one of whom said, “I have no concerns about privacy here.”

We found that up to date policies and guidance were available for staff in relation to safeguarding adults and children. This included information on how to make a safeguarding referral. We were told by the practice manager that all staff, apart from one, had undertaken safeguarding training appropriate to their role. We spoke with one member of staff who told us, “The training opened my eyes to different forms of abuse. We have a procedure to follow if we have a concern.”

We saw that paper medical records were stored securely and were accessed promptly when required. We were assured there was a procedure in place for checking that confidential information was stored securely as part of the end of day checks.

We spoke with six people about how they were involved in decisions regarding their care and treatment. One person told us, “They do listen to you. It is not like a conveyer belt, in and pills.” One clinician said, “I give them the information they need to make their choice.”

We found there were not suitable arrangements in place to ensure people’s privacy and dignity. On two occasions we saw staff members enter a treatment room without realising a person was using the room. We noted the treatment room and the room used for intimate examinations did not have a curtain round the examination couch.

We saw people with chronic diseases were reviewed. One person said, “Yes they do discuss my asthma. They have called me in yearly for reviews.”

Staff had an acceptable level of knowledge about the types of abuse and how they would recognise abuse. The provider was not able to inform us how to refer a safeguarding concern to social services. We were not assured that safeguarding concerns were responded to appropriately.

There was a comprehensive competency based induction in place. We spoke with nine members of staff all of whom felt supported. One member of staff said, “I feel very supported.” Staff received appropriate training to enable them to undertake their role effectively.

There was guidance available to staff relating to information governance. We found the paper medical records of people who used the surgery were not stored securely.