Letter from the Chief Inspector of General Practice

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We carried out an announced comprehensive inspection at The Chantry Health Group on 4 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.
• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment.

• 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.

We saw one area of outstanding practice:

• Nursing staff used a memory box to occupy patients with dementia whilst their carer received treatment. (The memory box contained items from the patients’ earlier life and times and helped reassure and calm them).

The areas where the provider must make improvement are:

• Have a system in place to include all necessary employment checks for all staff.
• Ensure that vaccines and other medicines are stored securely.
• Put in place a system to monitor the use of prescription forms.
• Improve security of patient information.

The areas where the provider should make improvement are:

• Have a system in place that ensures learning from significant events is embedded.
• Carry out clinical re-audits to ensure improvements have been achieved.
• Undertake a formal risk assessment for non-clinical staff chaperoning without having had a DBS check.
• Ensure staff appraisals occur annually for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chantry Health Group on 19 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We previously inspected the practice on 4 August 2016 we found the practice was Good overall and Requires Improvement for providing Safe services as they were in breach of regulation. We had asked the provider to improve how medicines and vaccines were stored, review governance issues surrounding the use of Smartcards, the safe handling of prescription forms within the practice and recruitment and selection procedures. At this inspection we found that these had all been addressed and the practice was now compliant with regulation.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The practice had a system in place to include all necessary employment checks for all staff.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• vaccines and other medicines are stored securely and there was a system in place to monitor the use of prescription forms.
• patient information was kept securely
• Learning from significant events is embedded.
• Clinical re-audits were undertaken to ensure improvements had been achieved.
• All staff chaperoning had a DBS check.
• Staff appraisals occurred annually.

Whilst we found no breaches of regulations, the provider should:

• Review and improve the existing systems and processes for the monitoring of consultations undertaken by advanced nurse practitioner(s).
• Undertake a documented formal risk assessment to ensure the emergency medicines held on site are appropriate for the activities provided by the practice.
• Review and improve the infection prevention and control measures to ensure appropriate standards of cleanliness and hygiene are met.
• Review and improve the monitoring of the process for seeking consent appropriately.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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