Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Argyle Surgery on 6 September 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 could make an appointment within a reasonable time with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was equipped to treat patients and meet their needs. However, the premises were in need of a general upgrade.
• 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.

We saw one area of outstanding practice:

• The practice had been awarded the contract to provide a nursing home service to 18 out of the 21 care homes in the London Borough of Ealing. ‘The Argyle Care Home Service’ started its multi-disciplinary team approach to deliver innovative primary care to over 900 care home residents in July 2013. The clinicians work with the in-house pharmacy team to deliver the service. The service is accessible 8:00am to 8:00pm, seven days a week, 52 weeks a year. Key achievements of the multi-disciplinary team work from 2013 to date include a 66% reduction in the use of antipsychotic medicines in nursing home based dementia patients, a 20% reduction in accident and emergency admissions and a reduction of more than 40% in admission to hospital for end of life care. The practice had won the British Medical Journal Primary Care Team of the Year award in 2015 for its care home service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

This scheduled inspection was brought forward as a result of concerns raised with the Care Quality Commission that the practice was not meeting essential standards of quality and safety.

During our inspection we spoke with seven people who used the service and eight members of staff. One person told us “it’s a very good practice, the doctors listen to me, they are very understanding and caring.” Another said “they look after my every need beyond the call of duty.”

All the people we spoke with told us they could always get an appointment when they needed one. One person said “I can usually get an appointment within a week and if it’s urgent they fit me in quicker.” Another said “I like the automated booking system, I once called late at night and got an appointment for the next morning.”

People were treated with dignity and respect. Their views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People were protected from abuse and staff were able to demonstrate how they would recognise abuse and the steps to take if they had any suspicions of abuse.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We reviewed the information available to us about The Argyle Surgery on 7 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.