This practice is rated as Good overall. (Previous rating October 2014 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at The Acorn Group Practice - Jackson on 17 July 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice had worked in conjunction with its PPG to improve the support offered to young carers. This involved liaising with the local carers’ charity and school nurse to increase the number of young carers recorded on the practice’s system, developing a young carers information pack, and presenting to the local PPG network and Regional CCG representatives in order to share learning.

The areas where the provider should make improvements are:

• Introduce a system for recording which clinical room stocks of prescription sheets are assigned to, and introduce and monitor a system for reviewing uncollected prescriptions.
• Provide training to non-clinical staff on identifying the signs of sepsis.
• Review the arrangements in place to address the areas of premises non-compliance highlighted in the infection prevention and control audit, to ensure that these adequately mitigate the risks identified.

• Whilst the practice was very pro-active in identifying and supporting young carers, they should ensure that the processes they have in place to identify adult carers are effective in identifying all patients who may require support.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

The Acorn Group Practice - Jackson, located in Twickenham in the London Borough of Richmond upon Thames in south-west London, provides a general practice service to around 8,000 patients.

We carried out an announced comprehensive inspection on 30 October 2014. The inspection took place over one day and was undertaken by a lead inspector, along with a GP advisor, a specialist advisor with a background in practice management and an Expert by Experience. We looked at a range of records, spoke with patients, members of the patient participation group (PPG), and staff including the management team.

Overall the practice is rated as Good.

Our key findings were as follows:

• The service is safe. There were systems in place for reporting, recording and monitoring significant events to help provide improved care. Staff were clear of their roles in regards to monitoring and reporting of incidents, safeguarding vulnerable people and children, and following infection prevention and control guidelines.

• The service is effective. Staff shared best practice through internal arrangements and meetings and also by sharing knowledge and expertise with external consultants and other GP practices. There was a strong multidisciplinary input in the service delivery to improve patient outcomes.

• The service is caring. Feedback from patients about their care and treatment via the national and practice-run surveys was very positive. Patients were treated with kindness and respect and felt involved in their care decisions. Almost all the comment cards completed by patients who used the service in the two weeks prior to our inspection visit had very positive comments about the care and service provided by the surgery.

• The service is responsive to people’s needs. The practice has an active Patient Participation Group (PPG) and worked with them to improve the service. The practice was responsive to the needs of vulnerable patients and there was a strong focus on caring and on the provision of patient-centred care. Information on health promotion and prevention, on the services provided by the practice and on the support existing in the community was available for patients.

• The service is well-led. The practice has a clear vision and strategic direction and was well-led.  Staff were suitably supported and patient care and safety was a high priority.

All the population groups including older people; people with long term conditions; mothers, babies, children and young people; the working age populations and those recently retired; people in vulnerable circumstances and people experiencing poor mental health received care that was safe, effective, caring, responsive and well-led.

However, there were also areas of practice where the provider needs to make improvements. 

The provider should:

Ensure the infection control audits cover different aspects of infection prevention and control including hand hygiene, use of personal protective equipment and environment cleanliness.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice