We carried out this inspection to determine if the provider had taken action to rectify the issues that were found at the previous inspection of this practice in February 2014.

On this visit we saw that the gaps in recruitment documentation for one member of staff had been resolved. We also saw that the emergency drugs, which were out of date when we visited in February, had been replaced.

On this occasion we did not speak with people who used the service.

We spoke with a number of patients. They were all satisfied with the information and support they were given by their doctor (GP). They felt that the GP gave them enough time during their consultation, and listened to what they had to say. One patient told us, “I have been coming here for years. The GP and the nurse listen and keep me informed”. Another patient said, “I am treated well by my doctor, he listens”.

Patients were able to make appointments in advance, and could telephone or visit the practice in person to make an appointment. One patient told us, “it is easy to get an appointment; I just have to phone in”. Another patient told us, “I can phone for an appointment. Even if they are full the staff will always try to fit you in”.

There were arrangements in place to deal with foreseeable emergencies, but these were not satisfactory. We found a number of the emergency drugs kept at the practice were out of date.

Staff were able to demonstrate they had a knowledge of safeguarding policies and procedures and they knew what to do if they had any concerns.

The practice had some recruitment procedures in place however these were not robust enough as not all staff had been appropriately vetted before starting work.

The practice had a number of systems in place to monitor the quality of the service provided, including facilitating a patient participation group.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Giles Surgery (Dr J Rosemen) on 18 August 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 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 improvement are:

• Ensure the practice is registered for the regulated activity maternity and midwifery services to cover the post-natal care provided by the practice.
• Ensure the guidelines for the correct segregation and disposal of sharps waste is followed to ensure compliance with legislation.
• Ensure blank prescriptions are tracked through the practice in line with national guidance.
• Ensure all staff know how to access clinical protocols relevant to their role.
• Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to them.
• Formulate a written strategy to deliver the practice’s vision.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice