Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection at Dr Chi Kee Liu on 27 October 2016. Overall the practice is rated as good.

We had identified a number of shortfalls at our previous inspection in February 2016 and issued four requirement notices as a result. During this inspection, we found that the practice had taken sufficient action to address the breaches in regulations.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Systems had been implemented to ensure that information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed. The practice had completed further risk assessments to protect patients and staff.
• 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. Staff appraisals had been undertaken or scheduled since the previous inspection.
• Feedback from patients about their care was generally positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice higher than others for all areas of care. For example, 99% of patients said that they had confidence and trust in the last GP they saw or spoke to in comparison to the local and national average of 95%.
• Information about services and how to complain was available and easy to understand. Improvements had been made to the complaints process to enable the practice to manage and act on patient feedback.
• Patients said they found it easy to make an appointment with a GP and that there was continuity of care. Urgent appointments were available on the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice proactively sought feedback from patients and staff. A virtual patient group had been developed to encourage further feedback from patients.
• The provider was aware of and complied with the requirements of the duty of candour.

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 Chi Kee Liu on 23 February 2016. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, reviews and investigations were not thorough enough.
• Risks to patients were not always assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. .
• The practice had a number of policies and procedures to govern activity.
• The practice had not proactively sought feedback from patients and did not have an active patient participation group.

The areas where the provider must make improvements are:

• Ensure that staff working as chaperones receive the correct training and security checks.

• Develop a robust system to ensure that emergency drugs and medical equipment are in date.

• Ensure that staff receive appropriate induction training, training updates and professional appraisal.

• Develop a system for managing and monitoring complaints.

• Ensure recruitment arrangements include necessary employment checks for all staff.

In addition the provider should:

• Record the minutes of clinical meetings to evidence learning from discussion.

• Improve the process for recording and cascading significant events throughout the practice.

• Risk assess the suitability of the oxygen cylinders held on the ground floor.

• Continue to promote and advertise for a Patient Participation Group (PPG).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The surgery had two smaller, part time branch surgeries at Earith and Bluntisham that we did not visit as part of this inspection.

We found the service to be welcoming with friendly staff. Information was displayed for people using the service, including health promotion, access to support services and other services available. There was a touch screen booking in facility in the waiting area and translations facilities were available if required. We spoke with six people who all spoke highly of the services that had been provided to them. We also spoke with staff who said they enjoyed working in the practice and felt supported in their work.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person said, "I have always been treated well here." Another person said, "All the staff; the doctor, nurses and receptionists are very polite."

Staff had received training in safeguarding children and were knowledgeable about safeguarding vulnerable adults procedures. They were aware of reporting any concerns to the surgery's lead for safeguarding issues.

Medicines in the dispensary were well managed. Some improvements to the monitoring of medicines kept separate from the dispensary would ensure better control of these medicines.

We found that the premises were safe and of an adequate size for staff to deliver the services provided by the surgery.

We reviewed the information available to us about Dr Chi Kee Liu on 11 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.