We carried out an announced comprehensive inspection at Clifton Road Surgery on 1 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems, process and practices in place to protect people from abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads.

• The practice had systems in place to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice discussed these in meetings, learned from them and improved their processes.

• The systems for the management of fridge temperatures did not always promote the safety of patients. For example, the practice were not able to demonstrate that they had followed their process to investigate a fridge temperature that had appeared to be out of range.

• 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.

• The practice achieved 100% of the available points in the Quality and Outcomes Framework with an overall exception reporting rate of 7%.

• There was evidence of actions taken to support good antimicrobial stewardship.

• The practice had reviewed and increased its workforce and employed additional clinicians with a varied skill mix to help meet the health and social needs of patients and the demand for access to appointments.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• Staff involved treated patients with compassion, kindness, dignity and respect and the National GP Patient survey results reflected this. In addition comment cards we received reported levels of satisfaction with the services at the practice and patients we spoke with provided positive feedback. For example, 94% of patients said the last time they saw or spoke to a GP, the GP was good or very good at listening to them.

• The practice had identified the needs of transgender patients and developed a policy to support their prescribing and psychosocial needs in line with shared care services.

The areas where the provider should make improvements are:

• Establish an effective system to track, monitor and review the prescribing of high risk medicines.

• Review the recently strengthened system to record investigation of discrepancies in recorded fridge temperatures to ensure that patients are kept safe.

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Clifton Road Surgery on 15 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

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

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.
• 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 practice had a clear vision about providing a quality and caring service in a safe way.
• Patients said they were treated with dignity, compassion and respect. They were involved in decisions about their care and treatment. Information was provided to help patients understand the treatment choices available to them.
• Information about how to complain was available and easy to understand.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice