Letter from the Chief Inspector of General Practice

When we visited The Red Practice on 9 August 2016,

to carry out a comprehensive inspection, we rated them as requires improvement overall.

 We rated them as good for the provision

of caring and well-led services, and requires improvement for the provision of

safe, effective and responsive services. 

Following this inspection we told the practice they must:

• Ensure infection control

  measures, including cleaning systems are maintained and the infection control action

  plan is fully implemented.

• Ensure that all staff have received the

  training, as required in order to undertake their role.

• Ensure that recruitment records are complete

  and include proof of identity.

• Ensure all staff who have unsupervised access

  to patients have been subject to a

  Disclosure and Barring Service (DBS) check.

• Review the appraisal system in order to

  ensure all staff have had an appraisal and the records of these are maintained

  on file.

• Review and take steps to improve patient

  telephone access to the service.

This inspection was an announced focused follow

up inspection carried out on 28 July 2017. Its purpose was to confirm that the

practice had carried out their action plan to meet the legal requirements in

relation to the breaches in regulations that we identified at our previous

inspection. This report covers our findings in relation to those requirements.

This report should be read in conjunction with the full report of our

inspection on 9 August 2016, which can be found on our website at

www.cqc.org.uk

.  

Please note that since our last inspection the practice has changed their

name to The Red Practice. Previously the practice was called Dr Sillick and

Partners.

The practice is now rated as good for the

provision of safe, effective and responsive services. Overall the practice is

now rated as good.

Our key findings were as follows:

• All staff who had unsupervised access to patients had been subject to a

  DBS check.

• The practice was concerned about the standard

  of the cleaning service that was being provided by the building owners. We saw

  evidence the practice had taken appropriate steps to resolve the issue.

• Clinical staff told us they always checked treatment

  rooms prior to using them and ensured the rooms were fit for purpose.

• All staff had  undertaken the essential training required in

  order to undertake their duties in line with their role and responsibilities.

• The recruitment records of staff that had

  beenrecruited since our last inspection were complete and included proof of

  identity.  The practice had reviewed the

  records of all other staff and ensured they had proof of individuals identity

  on file.

• All staff had, had an appraisal within the

  last 12 months and  records of these were

  maintained on file.

• The practice had recruited an additional

  receptionist whose main role was answering and responding to telephone calls.

• We saw data which showed patient feedback

  regarding getting access to the service had improved.  For example, 70% of patients described their

  experience of making an appointment as good compared with the clinical

  commissioning group average of 70% and the national average of 73%. This was a

  significant improvement from the previous year’s survey when this area scored

  59%.

However, there were areas of practice where

the provider should make improvements.   The provider should:

• Continue to take action to resolve their

  concerns about the cleaning service they receive and ensure an adequate

  standard is maintained on a day by day basis.

• Continue to monitor, review and take steps to

  improve patient telephone access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sillick and Partners on 9 August 2016. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they did not always find it easy to make an appointment with a GP, however, there was continuity of care, with urgent appointments available the same day.
• The practice was well equipped to treat patients and meet their needs. However, the practice had difficulties in maintaining the building due to the current arrangements with the property landlord. For example the cleaning arrangements did not ensure the risk of infection was minimised and the current telephone system hindered patient access.
• There was a clear leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

• Risks to patients were generally assessed but not always well managed. For example, the practice’s risk assessment for staff undergoing a Disclosure and Barring Service check (DBS) did not fully consider all risks regarding unsupervised access to patients.
• The training and appraisal systems did not ensure all staff had the training required for their roles and appraisals for all staff had not taken place.

The areas where the provider must make improvement are:

• The provider must ensure infection control measures, including cleaning systems are maintained and the action plan is fully implemented.
• The provider must ensure that all staff have the training required to undertake their role.
• The provider must ensure that recruitment records are complete and include proof of identity.
• The provider must ensure all staff who have unsupervised access to patients have been subject to a DBS check.
• The provider must review their appraisal system to ensure all staff have an appraisal and these records are maintained on file

• The provider must review and take steps to improve patient telephone access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with six staff, which included clinical staff. We spoke with seven patients and received questionnaire responses from five other patients. We were told that another practice in the same health centre had recently closed, and The Red Practice had taken on additional patients as a result of the closure.

During our inspection we saw that staff treated patients with respect and protected their confidentiality. Patients told us "The staff are really good” and “The doctors are wonderful.”

Patients told us that they felt well informed during their consultations. Patients told us "They explain what needs to happen but I decide” and “The nurse gives me advice.” Patients told us they were happy with their care at The Red Practice. For example, one patient told us "I’m happy. They meet my needs.”

We saw that the areas of the building within the control of The Red Practice were clean and tidy. The communal areas managed by the landlord were clean. However, the decoration of communal areas was shabby and the toilets were not furbished to a standard that ensured hygienic cleanliness. We saw that this was being addressed.

We saw that staff had received training and appraisals and staff confirmed that they felt supported. A staff member told us “Yes, I can get help and advice when I need it.”

There was an effective complaints procedure in place and complaints were responded to appropriately.