Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 30 August 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced inspection at Dr Encarnacion Ruiz-Gutierrez on 1 February 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• 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.
• Staff involved patients in their care and decisions about their treatment and treated them with compassion, kindness, dignity and respect. Patients confirmed this.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review the results of the National GP Patient Survey and look at ways to improve performance as regards local and national averages.
• Consider introducing a system to record the actions and outcomes of MHRA alerts.
• Consider recording verbal complaints so that trends (if any) can be identified.

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 Encarnacion Ruiz-Gutierrez

on 30 August 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 recording significant events.
• Risks to patients were assessed and well managed. However the practice should regularly review significant events and ensure staff had read all practice policies.
• 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.
• 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. However we did not see any information on display for patients about the interpreting service. 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. However the practice needed to increase opportunities to seek and act on feedback from patients for the purposes of continuous evaluation and improvement of the service.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Carry out regular reviews of significant events to aid in the identification of trends.

• Review accessibility of the emergency alarm switch/process for alerting staff to an emergency in the disabled toilet.

• Ensure staff have read practice policies to ensure they are being correctly implemented.

• Ensure fire risk assessments include details of actions taken and the due date.

• Take appropriate action to bring the availability of interpreting services to patient’s attention.

• Improve opportunities to seek and act on feedback from patients for the purposes of continuous evaluation and improvement of the service.

• Keep a copy of the business continuity plan off site.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During our visit to the surgery we spoke with two patients, the practice manager, and the receptionist. People who used the service told us that the GP explained treatment options. One patient said the "doctor always listens and explains well what is going on." Staff were described as “very good” and “just lovely.”

Patients we spoke with told us of their experience of the practice. Patients told us that the clinical staff took time to discuss and explain their care and treatment to them. All were happy with the service they received from the practice.

People received care, treatment and support that met their needs and protected their rights.

There were effective systems in place to reduce the risk of infection.

We saw that the building was recently renovated, accessible to people with different types of disabilities. The design of the building and consultation rooms ensured that each patient’s privacy was protected.

Staff received training appropriate to their roles, and some competency checks were in place. Staff told us they felt they were encouraged to continually learn and to practice to a high standard.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The practice did not have an organised programme of audits in relation to the quality of the services.