Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Akester and Partners on 17 November 2016. The overall rating for the practice was good. However, a breach of the legal requirements was found which resulted in the practice being rated as requires improvement for providing safe services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Dr Akester and Partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection and took place on 16 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulation that we identified in our previous inspection on 17 November 2016. This report covers our findings in relation to those requirements.

The practice has made the required improvements to meet the legal requirements in the key question of safe and is rated as good.

Our key findings were as follows:

• The practice had ensured that sufficient arrangements were in place for the safe management of medicines, including the recording and dispensing of controlled drugs.

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 at Dr Akester and Partners in Kirkby Malzeard and the branch practice at Masham on 17 November 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and reviewing significant events.

• Although risks to patients who used services were assessed, the systems and processes to address these risks were not always implemented well enough to ensure patients were always kept safe as we found that medicines were not always safely managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from people who used the service was continually positive about the way staff cared and treated them. There was a high level of praise for staff. There was a strong, visible, person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity. Relationships between people who used the service, those close to them and staff was strong, caring and supportive. These relationships were highly valued by all staff and promoted by leaders.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.

We saw areas of outstanding practice including:

• The practice demonstrated a proactive and responsive approach to understanding the needs of vulnerable patients and to deliver care in a way that met their needs. For example, the practice had well established shared care arrangements for patients who had drug and alcohol dependence. The practice was able to demonstrate the significant benefit this service had had for these patients.
• The practice was proactive in identifying and responding to patients who were carers or who experienced social isolation. They worked closely with volunteer groups. For example The Red Cross. The practice was able to demonstrate the positive impact this work had had for 2.4% of their population.

There was an area of practice where the provider must make improvement:

•  Ensure sufficient arrangements are in place to ensure medicines are always safely managed.

The areas where the provider should make improvement are:

• Review the arrangements for recording controlled drugs in accordance with relevant legislation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice