Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Brook Square Surgery on 12 November 2014.

We rated the practice overall as Good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Staff told us there were usually enough staff to maintain the smooth running of the practice and there were always enough staff on duty to keep patients safe. However, we identified during the inspection an area of concern regarding the safety of some patients.
• The practice had systems in place for monitoring the needs of patients and mechanisms for encouraging patients to attend for routine reviews, for example annual health checks and cervical smears. There was a good skill mix among the staff group with staff having a range of qualifications.

• Patients told us they were treated with dignity and respect. They said staff listened, were helpful, supporting and caring.

• The practice was responsive to the needs of patients and took into account any comments, concerns or complaints to improve the practice. The practice reviewed the needs of its local population and engaged with the NHS Area Team and Clinical Commissioning Group (CCG) to secure improvements to services where these were identified.

• The practice was well led, with an accessible and visible management team with clear direction. Governance systems are processes were in place and quality management information was available and used to improve outcomes for patients.

We saw one area of outstanding practice:

• The practice had appointed a Health and Social Care Co-ordinator to lead on the management of patients on the care management register. This role involved close working with nursing and residential homes to devise care plans for patients.

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

Importantly, the provider must:

• The practice must ensure they assess and manage all risks and put actions in place to mitigate risk in a timely way. Since June 2014 the practice had assumed that all GPs had medical indemnity but one GP did not. Whilst the practice had attempted for three months to confirm the GP was insured, at the time of our inspection the practice had not received confirmation and had not taken steps to ensure the GP was insured in the interim. The practice responded appropriately on the day of the inspection to mitigate the identified risk and this issue was referred to NHS England. We believe that this issue pertains to all of the population groups, although overall our view is that you provide good services that are effective, caring, responsive and well led, for each of the population groups.

The provider should:

• Ensure the safeguarding lead is trained to Level 3 in safeguarding adults and children.

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 of this practice on 12 November 2014. A breach of legal requirements was found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to ensuring that all staff had the appropriate medical indemnity insurance in place and responding to a known risk.

We undertook this focused desk based inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for on our website at www.cqc.org.uk

Our key findings across the area we inspected were as follows:

The provider had completed all the actions within the action plan that was put in place and provided to CQC at the time of the comprehensive inspection. They demonstrated they had closely monitored the management of the identified risk in a timely and appropriate way. There was clear evidence of involvement and consultation with NHS England and CQC throughout.

A range of actions had been put in place and embedded within the practice to avoid a recurrence of such an event. 

The provider demonstrated that they had met the legal requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice