Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Humbleyard Practice on 20 December 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, appropriately reviewed and addressed.
• 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.
• Feedback from patients about their care was positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice in line with, or above, others for most aspects of care.
• 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.
• 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 well supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider should make an improvement is:

• Ensure near miss errors identified by staff before medicines were dispensed to patients are recorded and monitored.
• Ensure that carers are proactively identified.
• Ensure that verbal complaints are recorded consistently.

We saw one element of outstanding practice:

• The practice proactively monitored children who did not attend their appointment and followed them up for potential safeguarding reasons. We viewed documented actions and responses for these situations and found this provided a safe approach to reviewing safeguarding needs for children. In October 2015 the practice had audited a week of consultations to confirm adherence to their policy of recording who accompanies a child to a consultation, and to check that staff were recording consent for vaccinations or intimate examinations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

When patients of all ages attended the practice for treatment, appropriate levels of consent were sought by clinical staff before the treatment or procedure was completed.

We observed staff talking with patients, looked at records and spoke with patients and staff during our visits to the three practice locations. We found that patients valued the service they received and had confidence in the care and support they received from the staff. One patient told us, "The service is as good, whatever doctor I see."

There were systems in place to reduce the risk and spread of infection although further improvements were needed to ensure these were effective.

Staff had access to training, received some professional development and were supported by their managers. However, staff did not always receive relevant mandatory training or an annual appraisal.

The service had comprehensive systems in place for monitoring the quality of the service they provide. Systems included; audits of health and safety, fire safety, portable appliance testing, auditing of disease registers, records and clinical governance. The views of patients were sought and their feedback was acted upon.