Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection for The Kings Family Practice on 21 April 2015. Overall the practice is rated as good. Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. The practice was also good for providing services for older patients, patients with long term conditions, families, children and young patients, working age patients (including those recently retired and students), patients who’s circumstances may make them vulnerable and patients experiencing poor mental health (including patients with dementia).

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.
• Risks to patients were assessed and well managed.
• The practice worked well with other services to provide treatment and support for patients that had a diagnosis of a mental health condition and/or substance abuse.
• 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.
• Information about services and how to complain was available and easy to understand.
• Patients were able to book routine appointment s with the GP at a time that suited them. Urgent appointments were 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Our inspection on 22 October 2013 found that people who used The Kings Family Practice were not always protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We found that the practice had their own safeguarding vulnerable adults policy for staff to work to and follow. However, this policy did not refer staff to the local Kent and Medway safeguarding policy. We also found that the practice had a whistleblowing policy that advised staff how and when whistleblowing allegations could be made. The policy stated that staff could approach an external body. However, it did not state who any of the external bodies were or how to contact them. The practice did not have a monitoring system in place to ensure qualified staff maintained their professional registration. For example, registration with the General Medical Council (GMC). At the time of our visit we could not verify whether administrators who acted as patient chaperones when other clinical staff were not available, had had police checks or disclosure and barring service (DBS) checks since beginning their employment. A risk assessment had not been completed regarding administrative staff acting as chaperones.

A compliance action was set asking the provider to take action regarding these concerns. They wrote to inform us that they had taken action and put measures in place to rectify the areas of concern found at this inspection.

We followed up on our inspection of October 2013 to check that action had been taken to meet the compliance action set. We found that The Kings Family Practice was able to demonstrate that they were meeting the compliance action set in order to rectify the areas of concern identified at that inspection.

The practices are operated by four GPs working in partnership and they are assisted by a salaried GP, two nurses, a health care assistant and nine administrative staff (One of which is the deputy practice manager).

The partners have interviewed candidates for the role of practice manager and hope to appoint someone in the near future. A new practice nurse has been also been recruited, to supplement the current team.

People we spoke with were happy with the care and treatment they received at the practice. People spoke highly of the staff and one person said "Staff here are brilliant". We found that people's needs were assessed and care and treatment provided was discussed with patients and delivered to meet their needs. People spoke positively about their experiences of care and treatment at the practice.

We found that whilst there were child and adult safeguarding policies in place, they did not link into the local Kent and Medway safeguarding policy.

We found that people were protected from the risks associated with infection because appropriate procedures were followed by staff. The practice was in the process of reviewing their infection control audits.

Medicines were kept safely, and there were processes to ensure the security of medicines and prescription pads.

There were some formal mechanisms and some documentation in place to indicate whether the practice was able to monitor or assure the quality of the service people received.