The Harvey Practice

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of The Harvey Practice on 7 October 2016 to assess whether the practice had made improvements to providing safe care and services.

We had previously carried out an announced comprehensive inspection at The Harvey Practice on 1 March 2016, when we rated the practice as good overall. The practice was rated as good for being effective, caring, responsive and well-led and requires improvement for providing safe care. This was because the employment checks necessary for locum staff were not consistently undertaken. Following our last inspection we asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time.

The practice was able to demonstrate that they were meeting the standards for safe care and is now rated as good for providing safe care. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report. A full copy of the report can be found on the CQC website at: www.cqc.org.uk

Our key findings across the areas we reviewed on 7 October 2016 were as follows:

• Recruitment checks on staff had been appropriately conducted, including locum staff.

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 The Harvey Practice on 01 March 2016. 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 report incidents and near misses.
• Risks to patients were assessed and well managed.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, patients requested anti-bacterial hand gel in the waiting area next to the check-in screen. This was provided by the practice.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority.

We saw several areas of outstanding practice:

• The practice was proactive in the care provided for patients over 75 years of age. A GP conducted weekly ward rounds in nursing homes. A dedicated GP was employed to provide proactive case management for patients over 75 years of age. The practice had plans in place to conduct weekly reviews of patients with the input of a specialist doctor in elderly medicine.
• The practice was proactive at improving diabetes outcomes for patients. The lead practice nurse for diabetes conducted educational sessions for clinical and support staff working in the nursing homes which the practice supports. Joint clinics were also run with the lead nurse and GP for diabetes and a diabetes specialist nurse every 6-8 weeks.
• The practice had a system in place to ensure that all referrals to secondary or tertiary services made by GPs were peer reviewed for appropriateness and content. This improved the quality and consistency of referrals.

However, there were areas of practice where the provider must make improvements:

• The practice must ensure that appropriate recruitment checks for locums employed by the practice are consistently undertaken.

There were also areas of practice where the provider should make improvements:

• The practice should review its processes for proactively identifying patients who may also be carers and ensure they receive appropriate support. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice