Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Garden City Practice on 27 April 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events.
• Staff had 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.
• 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.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

When we inspected two of the three branch surgeries operated by Dr Hanak and Partners on 23 December 2013 we found that three of the essential standards were not being met. There were shortfalls in cleanliness and infection control, the management of medicines and the storage of people's records. We judged that these shortfalls had a minor impact on people using the service and we required the provider to make improvements. The provider wrote to us and said they would be compliant by the end of March 2014. We revisited the Guessens Road and Knightsfield surgeries on 25 April 2014 to see whether those improvements had been made.

We found that the provider had employed a new cleaning company and that this had led to a significant improvement in the way the surgeries were cleaned. The surgeries had also been subject to a deep clean and many items of equipment and furniture that presented a risk of infection had been removed. Staff had received infection control training and were confident in their use of appropriate safe techniques. Further training was also planned. The provider had improved their systems for checking the effectiveness of their infection control policy. This included the carrying out of an infection control audit and responding to the shortfalls that the audit identified.

We found that the provider had installed new, wall-mounted, lockable cabinets for the storage of medicines that did not require refrigeration. We also saw that medicines were tracked by means of a recording system that ensured they were within their expiry dates and safe to use.

We found that records were stored securely in a room at one of the surgeries that had been converted for that purpose. Summaries of the records of new patients were checked for accuracy at the point of their first visit with a doctor.

We found both the surgeries we visited, Guessens Road and Knightsfield to be welcoming with friendly staff. We did not visit Haldens surgery.

Information was displayed for people using both surgeries, including health promotion, access to support services, information about the practice and other services available, although this was limited at the Knightsfield surgery. Appointments could be made for all three surgeries in person, telephone, or via the internet by using the practice's website.

We spoke with six people during our inspection, who all spoke highly of services provided to them. We also spoke with staff who said they enjoyed working in the practice.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person said, "I haven’t been coming here for that long, but everything seems very well run.” Another told us, “I am here quite often, particularly with my children. The staff are very helpful and friendly.”

We saw that both practices were untidy. There were areas that were unclean including some of the surgeries and places where medical equipment was stored.

We saw that there was a system to ensure repeat prescriptions were available promptly. However, we found medicines kept at the practice that were not stored safely.

Many of the staff had been employed for a number of years and were familiar with the practice. Staff were trained and supported through a variety of means including meetings and appraisals.

The practice had an electronic records system, which was used by all staff. Paper records received from other areas, when people changed practices, were not stored in a way that ensured that they were kept confidential.