Archived: Clarence Park Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Clarence Park Surgery on 11 February 2015. Overall the practice is rated as Good.

Specifically, we found the practice was good for providing an effective, responsive, caring and well led service. They required improvement for providing safe services in relation to their medicines management. Overall they were good for providing services for all of the population groups.

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 not always recorded, monitored, appropriately reviewed and addressed. For example, infection control audits did not always identify areas for improvement and significant events were discussed but had not always been recorded.
• Risks to patients were often assessed and well managed. However, there were some aspects that required improvements and review including medical emergencies, security arrangements.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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.

We saw one area of outstanding practice:

• One of the nurses had achieved the Queens Nursing Institute in 2014. This award recognises a nurses commitment to the values of community nursing, to excellent patient care, and to a continuous process of learning and leadership. Locally, they were leading improvement projects and redesigning services to improve care for patients. The award was for the nurses development, teaching and examination of students undertaking a post graduate diploma/MSC at the university of Cardiff medical school. They also had an honorary contract as a Senior Lecturer at a Hospital in the Isle of Man where they facilitated and supported pre-registration learning and non-medical prescribing course. Additionally they were mentoring a nurse who had been a newly qualified in minor illness. The nurse was well established within the area and when they had moved to this practice other patients had joined this practice due to the quality of care received. They ensured patients were consistently seen to complete treatment and necessary tests in a timely manner.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider must:

• The practice must risk assess medical emergency equipment and medicines in reflection of current guidelines and review security of all medicines including vaccine refrigerators and where emergency medicines were kept.

Additionally the provider should:

• Review procedure for recording significant events to ensure these are recorded when they happen and any action to address the event.
• Review access to the front entrance of practice to improve accessibility for all patients.
• Review how consent was recorded for joint injections including any advice and guidance provided during consultations.
• Review and risk assess security of consultation rooms.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice