We spoke with seven people including a representative of the Patient Reference Group (PRG). All spoke highly of the staff who worked at the practice. People said that they were pleased with the service that they had received. Comments included “The doctors listen to what I have to say. If ever I have a problem; then something is done about it!” and “My wife and I have only ever had the best of care here. It's because a good team pulls together. I have no complaints. I can get an appointment if I need one and if I want to see a named GP, I only need to wait a few days. It could not be better."

After the inspection CQC was contacted by one Bramhall Medical patient who said that older people could not access primary medical services easily and that those concerns had been shared by the patient with NHS Stockport.

People we spoke with on the day of inspection said that they were involved in decisions about their care and that they could discuss their treatment options with the doctor.

We looked at how adults or children might be identified and safeguarded from abuse and found that proper arrangements were in place.

We saw that the premises were clean and generally in a good state of repair. A programme of development of the premises was seen. However, we had concerns around fire safety precautions in parts of the building.

Arrangements were in place to ensure that pre-employment checks and satisfactory recruitment procedures were in place.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bramhall Health Centre on19 October 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. Significant events had been investigated and action had been taken as a result of the learning from events.

• Systems were in place to deal with medical emergencies in the practice and staff were trained in basic life support.

• Systems were in place to reduce risks to patient safety. For example, infection control practices were good and there were regular checks on the environment. However, some additional checks were required to fire safety and electrical safety.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.

• Staff had generally been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. However, not all staff had been provided with safeguarding training.

• Staff felt well supported in their roles and had undergone a regular appraisal of their work.

• Feedback from patients about the care and treatment they received from clinicians waspositive overall. Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.

• Improvements had been made to the appointments system in response to feedback from patients. Urgent appointments were available the same day and routine appointments could be booked in advance.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• Complaints had been investigated and responded to in a timely manner.

• There was a clear leadership and staff structure and staff understood their roles and responsibilities.

• The practice provided a range of enhanced services to meet the needs of the local population.

Areas where the provider should make improvement are:

• Review the procedures for patient specific directions (PSDs) to ensure they support the safe administration of medicines.

• Ensure the system for managing safety alerts clearly demonstrates the actions taken.

• Carry out a risk assessment with regards to the decision not to carry emergency medicines on home visits.

• Ensure a system is in place for the regular check of equipment carried in GPs’ bags.

• Ensure all required health and safety related checks are carried out at appropriate intervals.

• Formalise the process for the induction of non-clinical staff.

• Review the information provided to patients about the complaints process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice