Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queenstree practice on 4 February 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.
• The practice had extremely good facilities and was well equipped to treat patients and meet their needs.
• 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 improvements are:

Recruitment arrangements should include all necessary employment checks for all staff in order to carry out specific roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

At our previous visit on 30 January 2014, we found that sufficient improvements had not been made to ensure staff were adequately supported to deliver safe, effective care. Most mandatory training was either out of date or had not been carried out. There was no system of supervisions and team meetings which would have allowed staff to raise issues or keep up to date. This resulted in us taking enforcement action against the provider.

At this inspection, we found that all staff including the GP's were now up to date with mandatory training such as health and safety, and safeguarding. Staff told us they had enjoyed completing the training and now felt happier and more confident in their jobs.

A new system for appraisals and supervisions meant that all staff were now given regular time on a one to one basis to raise issues and discuss their roles. Regular team meetings were being held which helped staff keep up to date with practice issues.

We found that these improvements meant that staff were now supported to deliver safe, effective care.

At the last inspection we found that staff were not supported to deliver care and treatment safely to an appropriate standard.

At this inspection we went back to check the action the provider had taken to ensure all staff were supported to carry out their roles. We looked at all staff records and found that no action had been taken to ensure that training was up to date by the date set out by the provider.

At the last inspection we found that staff appraisals had been up to date. At this inspection we found that no supervision or staff meetings had taken place. We spoke to five members of staff who told us they felt unsupported in their role. We found that there was no supervision policy in place.

We found that staff training was not up to date

The manager had taken action to implement an induction policy for new members of staff. This meant that new members staff would benefit from a structured period of induction.

We found that people were still not protected from the risks of unsafe or inappropriate care and treatment because staff were not supported to deliver care and treatment to an appropriate standard.

We spoke with four patients who told us that they liked the practice, the staff were friendly and they were able to book appointments convenient to them. One patient said, “All the staff and the GPs are very good. I always get an appointment; you just ring in the morning and get in the same day.” Another patient told us, “They treat us well; we have been coming here for a while. They send out reminders for booked appointments, we find that useful.”

We observed staff speaking with people on the telephone and in person. We heard that staff were friendly and polite and offered choices to patients. We found that people who used the service were treated with dignity and respect.

We found that people were protected from the risk of infection as treatment was delivered in a clean and hygienic environment.

We found that staff received regular appraisals; however staff were not up to date with training. This meant that staff may not be able to carry out their role effectively

We found there was an effective complaints procedure available within the practice.