Letter from the Chief Inspector of General Practice
This inspection was an announced focused inspection carried out on 7 September 2017 to confirm that the practice had carried out improvements that we identified in our previous inspection on 11 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
Overall the practice is still rated as good, and requires improvement for the safe domain. Our key findings were as follows:
- The systems and processes to systematically record safety alerts had been improved and showed the alerts had been recorded, actions had been taken, and learning shared. This had improved the oversight of safety.
- Annual infection prevention and control audits had been undertaken. However, we found out of date items in a clinical room and there was no system in place to check expiry dates of equipment.
- We reviewed four personnel files and found appropriate recruitment checks had been undertaken prior to employment.
- We found that there was a system to code patient records on the clinical system for children who did not attend a hospital appointment.
- We reviewed three policies and found them to be up-to-date and reflective of current practice.
- We reviewed the system for staff appraisals and found there was a comprehensive log to track when appraisals were due. We checked five staff appraisals and found these had all been completed in the last year.
- The practice had improved the support offered to carers. There were leaflets in the waiting room which signposted carers to support groups and the practice had developed a ‘carer’s prescription’. This ensured that if a carer became unwell, the practice had systems in place to support both the carer and the person being cared for. The practice had identified 54 patients as carers (0.5% of the practice list).
- The practice had recognised that results from the GP patient survey, published in July 2017, were in line with or below local and national averages for access. The practice had previously been using locum GPs but had employed two new partners in June 2017 to improve continuity of care. The practice had also employed a minor illness nurse. Other details of the action plan to improve patient satisfaction were; employing an emergency care practitioner, employing a pharmacist and changing the phone lines to a queue based system. They planned to complete a patient survey to assess whether their action plan was effective. The practice planned to complete these actions by the end of 2017. We spoke with nine patients on the day of inspection and eight of these were satisfied with access to the surgery. One reported difficulty accessing the same GP for continuity.
The areas where the provider should make improvements:
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Continue to proactively identify and offer support to carers.
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Continue to assess the impact of improvements made relating to patient’s access to services.
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Implement a system to monitor expiry dates of equipment in clinical rooms.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice