Letter from the Chief Inspector of General Practice

Quincy Rise Surgery was previously registered with the Care Quality Commission (CQC) as a partnership provider. A change of provider took place in January 2017 when the practice re-registered as a single handed GP. The previous GP partner had left in July 2016. We first inspected Quincy Rise Surgery across two dates on 9 March and 4 April 2016.

As a result of our inspection visits, the practice was placed in special measures and was rated as inadequate overall. This was because we identified regulatory breaches in relation to regulation 12 for providing safe care and treatment and regulation 17 due to inadequate governance arrangements. As breaches of legal requirements were found we issued two warning notices and a requirement notice. We carried out an announced focused inspection at Quincy Rise Surgery on 18 July 2016 to focus on the areas identified in the waning notices. Although we saw that improvements had been made, the practice did not fully meet the requirements of the warning notice for Regulation 12: safe care and treatment HSCA (RA) Regulations 2014. We carried out an announced comprehensive inspection at Quincy Rise Surgery on 23 November 2016 to see if improvements had been made in line with the special measures period of six months following publication of the final report. Overall the practice was rated as good and was taken out of special measures. However we rated the practice as requires improvement for well led having found that governance systems and processes were not always effectively operated to support a well led and open cultured team. The reports for the inspection carried out on 9 March and 4 April 2016, July 2016 and November 2016 can be found by selecting the ‘all reports’ link for Quincy Rise Surgery on our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection at Quincy Rise Surgery on 2 October 2017, the first inspection under the new legal entity. The practice is rated as good overall.

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.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance and had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• The practice maintained appropriate standards of cleanliness and hygiene.
• Appropriate recruitment checks had been undertaken prior to employment although satisfactory information about any physical or mental health conditions relevant to a person’s ability to carry out their role had not been obtained for all staff.
• Most results from the national GP patient survey published in July 2017 showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. Where scores were below average the practice was able to demonstrate an awareness and mitigation.
• Information about services and how to complain was available and the practice proactively acted on complaints posted on the national website, NHS Choices. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients found it easy to make an appointment and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by the management team.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Ensure health and safety arrangements minimise the risks to patients, staff and visitors.
• Prior to employment, obtain satisfactory information about any physical or mental health conditions relevant to a person’s ability to carry out their role.
• Increase awareness of practice performance against the new Dudley Clinical Commissioning Group Provider Outcome Framework.
• Explore ways in which to increase the number of patients on the carers’ register and identify those patients who also acted as carers on the clinical system.
• Continue to monitor and further improve the patient satisfaction scores.
• Include information on how to make a complaint on the practice website.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice