Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Longcroft Clinic . 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.
• 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.
• Urgent appointments were available on the day they were requested. However, some patients told us that they sometimes had to wait for non-urgent appointments.
• 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

This was a follow up inspection to check the provider had taken the required actions to meet essential standards following our previous inspection in January 2014.

During this inspection we spoke with five members of staff including GPs, the practice manager, the practice nurse and reception staff.

We found that people were protected from abuse through the provision of suitable training of staff, the presence of clear policies and the availability of information to staff and people who used the service.

The provider had implemented processes to ensure people were protected from the risk of infection. Patients were cared for in a clean, hygienic environment. All staff had undergone infection control training appropriate to their role. Records of the Hepatitis B status of individual staff were maintained. The provider was able to demonstrate they had suitable arrangements in place to reduce the risks of exposure to legionella bacteria which is found in some water systems.

The provider had ensured that appropriate systems were in place to manage medicines. Records demonstrated that internal auditing to check the correct storage of medicines was carried out effectively.

The provider had taken steps to improve their recruitment processes. A revised recruitment policy had been developed and appropriate checks were undertaken before staff began work. Personnel records had been updated to include evidence that all staff had undergone criminal record checks via the Disclosure and Barring Service (DBS).

Since our last inspection, the provider had implemented some processes to identify, assess and manage risks. However, the provider remained unable to demonstrate that risk assessments had been completed for areas such as control of substances hazardous to health (COSHH), moving and handling and health and safety within the environment. There was no evidence of a fire risk assessment relating to the premises.

We spoke with patient's who used the service, staff, nurses and doctors. People told us that they were happy with the service they received. One person told us, "It’s a lovely place. I never have to wait and everyone is always so kind". Another person told us, "Super (service). I never feel rushed even though I know they’re busy".

Staff we spoke with did recognise what constituted ‘abuse’ and were able to tell us which services they would report any concerns to.

We looked at five staff files and found that four did not have a criminal record checks via the Disclosure and Barring Service (DBS). We saw that that no assessments had been carried out with regards to the potential risks involved in using staff without DBS clearance to undertake duties where they came into contact with vulnerable people and children.

We spoke with one of the staff members regarding their understanding of decontamination procedures in the surgery. The description for the decontamination processes was explained to us and was in line with Decontamination Guidelines; For example, wiping down all surfaces with alcohol based solutions, disposal of clinical waste and the use of Personal Protective Equipment (PPE). One patient we spoke with told us "The place is always spotless". Another person said “Yes, it always seems very clean”.

The provider was not able to demonstrate that they