Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chesterfield Drive Surgery on 21 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows;

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, and addressed. Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.

We saw one area of outstanding practice:

• One of the GPs worked as a MacMillan GP for the area and as such shared in depth knowledge of cancer care. The practice treated all new patients with cancer diagnoses as significant events.

The areas where the provider should make improvement are:

• Ensure that the practice’s computer system indicates links to the next of kin of children that are deemed vulnerable.
• Improve ease of access to policies and procedures for staff.
• Ensure annual reviews for learning disability, mental health and dementia patients are undertaken in a timely way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Following our inspection on the 11 December 2013, we found that the provider was not meeting some regulations of quality and safety. We had concerns regarding the emergency medicines and equipment and the auditing of these. In addition, we were not assured that the refrigeration equipment for storing medicines was suitable for its purpose and the complaints procedure was not brought to the attention of people who used the service. These related to the branch surgery at Landseer Road.

During our inspection on 18 March 2014 at the branch surgery at Landseer Road, we found improvements had been made.

We found emergency medicines and equipment were available. The medicines were checked monthly and documented. We were assured that a process was in place for recording the checks of the equipment.

We saw that a new vaccine refrigerator had been purchased and refrigerator temperatures were monitored and documented. There was evidence that appliance testing of equipment had been undertaken to make sure that it was safe. We spoke with one member of staff who told us, “Things have got more organised here (branch surgery).”

We found information about the complaints procedure was available in the waiting room, with notices provided in Bengali. We spoke with one member of reception staff about complaints. They told us that they would, “Try to resolve it, but if they wanted to take it further we would sit with them and fill in the complaint form with them.”

We visited both of the provider's surgeries. People can use either surgery, but the branch provided most of the care for the local Bangladeshi population. We found some reception staff at this surgery were able to speak the main languages used by local people.

We looked at how well people were involved in decisions about their care and treatment and spoke with six people about this. One person told us they had been prescribed medication and the GP, “Explained how to use it and how it worked.” Another person said they were not really involved.

Four people told us their health was regularly reviewed. One person said, “I am reviewed by the nurse and my medication is reviewed by the GP.”

We could not be assured that medicines were safely stored at the branch surgery. There was no documented audit process in place to check the emergency medicines. The temperatures of the three refrigerators at the branch surgery were not being checked. Some of the records had been completed retrospectively.

We saw that staff received a range of training relevant to their role. One staff member said, “My induction was fine. We used a DVD and had online training.”

We looked at the written records for four complaints. There was an effective system in place to acknowledge, investigate and respond to complaints, but the procedure was not well advertised. None of the eight people we asked was aware of the procedure. One person said, “I have not seen any information on complaints.”