Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 8.30am on 9 December 2015. 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 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. However, patients reported that they often had to wait a long time after their appointment time to be seen.
• The practice had reasonable facilities and was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice 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 improvement are:

• Provide annual basic life support training for non-clinical staff.

• Display more prominently information in the waiting room including a chaperone notice, translation services, and support services.

• Provide nursing staff with training in conducting mental capacity assessments.

• Carry out clinical audit to demonstrate on-going quality improvement.

• Put in place measures to address over running appointments as identified by patient feedback.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Shirland Road Medical Centre is a GP service located in the London Borough of Kensington and Chelsea. The provider is registered with the Care Quality Commission to provide two regulated activities: diagnostic and screening procedures and treatment of disease, disorder or injury at one location, Shirland Road Medical Centre.

During our visit which took place over one day, we spoke with two GP’s, two practice nurses, the practice manager and three administrative staff. We spoke with nine patients and a member of the patient participation group (PPG).

Shirland Road Medical Centre provided a caring, effective and responsive service. Patients’ needs were suitably assessed and care and treatment was delivered in line with current legislation and best practice.

Medicines for dealing with medical emergencies were held at the practice and staff had received training in cardiopulmonary resuscitation (CPR). However, some improvements were needed to ensure the safe management of medicines, specifically controlled drugs which had not been monitored and recorded in line with requirements.

The practice was clean but regular infection control audits had not been undertaken and not all staff had received annual training in infection control as identified by the practice as mandatory training.

The practice had inter-agency safeguarding policies and procedures. All staff had received training in safeguarding children and some staff had received training in safeguarding vulnerable adults but training had not always been within the timescale outlined in the policy or to the required level.

There were formal processes in place for the recruitment of staff. However, a disclosure and barring service (DBS) check (formally known as a criminal record bureau (CRB) check) had not been obtained for all staff and a risk assessment had not been completed for those staff assessed as not in need of a check. This meant patients were not fully protected against the risks associated with the recruitment of staff.

The practice was well-led on a day-to-day basis but improvements were needed to develop a more strategic approach to the management and planning of the service.

The practice delivered high quality patient care through an ethos and culture that was caring and responsive. All staff were clear about their role and responsibilities and the ethos and values of the practice. However staff were not always given the support they needed to do their job.

The practice experienced a high turnover of patients and the demographics of the population indicated that patients had complex needs with crisis situations being dealt with on a daily basis. Despite the complexities, the doctors offered 15 minute appointments for most of their practice hours.