Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Roselawn Surgery on 8 November 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.
• Overall, risks to patients were assessed and well managed; however, further consideration of the role of the nurse practitioner was needed in order to ensure that risks are identified and mitigated.

• 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; however, further consideration of the role of the nurse practitioner was needed in order to ensure that arrangements are in place to monitor and support this extended role.
• 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; however, patients had to request complaints leaflets from reception staff. Improvements were made to the quality of care as a result of complaints and concerns.
• Overall, 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 considered feedback they had received about appointments running late, and had made changes to their appointment system in order to address this.
• 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 management. The practice proactively sought feedback from staff and patients, which it acted on.
• The practice had effective governance arrangements in place; however, in some cases records, such as meeting minutes and records of audits, lacked detail.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• They should risk assess the role of the nurse practitioner, including a consideration of the scope of her knowledge and competence, and ensure that arrangments are in place to mitigate the risks identified.
• They should review the risks associated with allowing staff to begin work at the practice without full background checks having been completed, to ensure that these are adequately mitigated.
• Ensure that complaints leaflets are available to patients without them needing to request them.
• Ensure that more detailed records are kept of management activity, such as meeting minutes and records of audits.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

People we spoke with who use the service told us they were happy with the service and were “never hurried” during appointments. One person had been attending the practice for many years, along with most of the other members of their family. Members of the patient participation group told us that they were able to raise concerns with the practice, and that the practice manager was good about responding. They also said the practice was receptive to making changes and improvements.

We observed that despite being busy on the day of our inspection, reception staff were available to assist people in a timely manner, and were professional and polite. We found that when we sat in the reception area, we could not hear what was said as people checked in for their appointments. We also could not hear what was being said when reception staff were on the phone. A sign displayed in the reception area asked people to stand back from the counter when another person was speaking to the receptionist, to ensure they had privacy.

We found that there were appropriate infection control measures in use at the practice and that medicines were adequately managed. We also found that people were protected from the risk of abuse because procedures were in place at the practice for safeguarding children and vulnerable adults, and staff demonstrated that they were aware of these procedures.