We carried out an announced comprehensive inspection at The Laurie Pike Health Centre on 27 February 2019. As part of this inspection we also visited the practices branch surgery; Shanklin House Surgery.

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 have rated this practice as requires improvement overall.

We rated the practice as requires improvement for providing safe, responsive and well-led services because:

• Feedback from patients was positive about the way staff treated people however there was a theme in feedback highlighting that patients struggled to access the service in a timely way.
• Although we noted many changes implemented to improve access, the practice could not demonstrate the impact of these changes at the time of our inspection.
• There were clear responsibilities, roles and systems of accountability in place however these systems did not always reflect good governance. For instance, we found gaps in some of the processes for managing risks and issues across various areas.
• The practice could not provide evidence to assure us that appropriate standards of cleanliness and hygiene were always met. Specifically, we identified gaps in the record keeping to support adequate infection prevention control.
• Although there was evidence of staff and external partner involvement to sustain high quality and sustainable, in some areas patient engagement had lapsed.

These areas affected all population groups so we rated all population groups as requires improvement.

We rated the practice as good for providing effective and caring services because:

• Quality and performance was positive across various care areas and where performance was below average, such as for cervical screening and exception rates; the practice could demonstrate improvement.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Continue to explore ways of improving uptake rates for childhood immunisations, cervical and bowel cancer screening.
• Explore ways of improving confidentiality measures for patients attending the branch practice at Shanklin House Surgery.
• Ensure fire safety measures provide details on fire assembly points for people for service users and staff at the branch practice, Shanklin House Surgery.
• Improve record keeping to reflect actions taken following the management of safety alerts and for the monitoring of prescription stationery.

We saw one area of outstanding practice:

The practice held carers events across multiple days during June and November 2018. The aim of the event was to increase awareness, identification of carers and to offer support and general health checks, screening and depression checks to their carers. The practice also used the event as an opportunity to carry out health checks for carers in addition to care plans for patients with Dementia. The practice carried out 52 health checks during the events and 13 Dementia care plans. Through these checks, clinicians also addressed biological, psychological and social issues and supported patients to make positive changes. In addition, a carers session called ‘Making Space’ was implemented at the practice every two weeks.

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

Letter from the Chief Inspector of General Practice

We completed a comprehensive inspection at Laurie Pike Health Centre on 5 March 2015. The overall rating for the practice is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains.

Our key findings were as follows:

• Systems were in place to ensure that all staff had access to relevant national patient safety alerts. Staff worked together as a team to ensure they provided safe, co-ordinated patient care.

• Infection prevention and control systems were well managed and staff had received appropriate training.

• Staff were friendly, caring and respected patient confidentiality. Patients we spoke with said that all staff were compassionate, listened to what they had to say and treated them with respect. We observed that staff at the reception desk maintained patient’s confidentiality.

• There was a register of all vulnerable patients who were reviewed regularly. Patients we spoke with told us they were satisfied with the care they received and their medicines were regularly reviewed. GPs carried out clinical audits to check that patients received the correct medicines for their health needs.

• The practice had a clear vision to deliver high quality care and promote good outcomes for patients. This was evident when speaking with staff and patients during our inspection. There was a clear leadership structure with named staff in lead roles.

• Teams of specialist staff were shared with other practices within the Vitality Partnership. Each team consisted of GPs and nurse who had specialist knowledge in dermatology and rheumatoid arthritis. The teams held regular clinical sessions at the practice to assess and treat patients who had skin and long term joint conditions. These patients would otherwise have been referred to a hospital.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice