Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chapel Street Medical Centre on 20 January 2015. We rated the practice as good overall.

Specifically, we found the practice to be good for providing effective, caring, responsive and well-led services. It was also good for providing services for the six population groups. It required improvement for providing a safe service.

Our key findings across all of the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed.
• The management of risks to patients was not robust. Some risks to the practice had been identified and addressed, but we found a number of areas during our inspection in which risks identified had not been appropriately assessed and acted on such as the provision of appropriate emergency equipment and medicines and legionella testing.
• Patients’ needs were assessed and care was planned and delivered according to best practice guidance. Staff had received training appropriate to their roles and further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect, although patients felt being involved and making decisions about their care treatment was an area for improvement.
• Information about services and how to complain was available and easy to understand but was not clearly displayed in the practice.
• Most patients said they found it easy to make an appointment with a named GP, urgent appointments were available on the same day. However, feedback from patients indicated patients were not satisfied with the practice opening hours.
• The practice had adapted the premises to ensure disabled patients could access the service. Facilities were also available for those with young children.
• There was a clear leadership structure and staff felt supported by management. However, there were areas the practice needed to improve on such as the management of risks including those relating to patient satisfaction.

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

The provider should:

• Ensure that robust and effective systems are put in place to protect patients from the risks of unsafe care such as not having certain emergency equipment and medicines and the absence of legionella testing.
• Ensure audits complete their full audit cycle in order to demonstrate improvements made to practice.
• Review how the service can improve patient satisfaction in relation to involvement in care, treatment decisions and accessibility to the practice in relation to opening hours and appointments.
• Ensure all staff who act as chaperones have a DBS check or should be risk assessed as to whether a DBS is needed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice