Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Belmont Health Centre on 8 December 2015. 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. All opportunities for learning from internal incidents were maximised.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients, was that the practice offered an excellent service and staff were caring, treated them with dignity and respect and often went “the extra mile”.

• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Ensure that annual fire drills are recorded and documented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with nine patients and the Chair of the Patient Participation Group. People told us they were happy with the treatment they received at the service. One person said "They give excellent care". Another person told us "The doctor gives good advice and lots of information. They tell me all the details and let me make up my own mind". A third person told us "Absolutely first class. Doctors are extremely good and the support staff all work very hard".

People told us they were generally able to access the service when they needed to. One person said "There's a lot of ways to book now, online or over the phone. I don't have any problems". Another person told us "It takes longer to get a routine appointment now, but I always see the same doctor and that's important for continuity of care". A third person said "It's always easy to get an appointment. I use the online facility which is wonderful".

We found that the service met people's needs in ways that protected their rights, and took some steps to protect people from the risk of abuse.

We saw that the premises were clean and met government standards for infection control.

Staff were skilled, qualified and experienced in their roles, and the provider maintained an appropriate recruitment and selection procedure.

We saw that the provider had a system in place to assess and monitor the quality of the service people received.

This practice is rated as good overall.

(Previous inspection: 21 November 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Belmont Health Centre on 17 May 2018 as part of our inspection programme.

At this inspection we found:

• There were processes in place to manage risk. 
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• We found that completed clinical audits were driving positive outcomes for patients.
• Although patients’ feedback highlighted issues with telephone access, the practice had acted to resolve this issue.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice was effective in flu immunisations for patients with a learning disability. Reasonable adjustments were put in place for those that had difficulty accessing the service.
• The practice provided a weekly minor surgery service to all patients in the Harrow area.

The areas where the provider should make improvements are:

• Review and amend the safeguarding children policy.
• Take action to ensure that all staff receive formal sepsis training and complete regular update training in a timely manner.
• Take action to ensure that water temperature checks at the branch surgery are carried out as per Legionella risk assessment recommendations.

• Monitor the systems or processes for managing test results to ensure all requested test results have been viewed and actioned.
• Continuously review exception reporting and take appropriate action where progress is not achieved as expected.
• Continue to monitor effectiveness of new telephone system and take action where required.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice