Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Swoffer and Hoshyar on 16 June 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Drs Swoffer and Hoshyar on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 27 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 16 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had clearly defined and embedded systems to minimise risks to patient safety, including those relating to legionella infection.
• The practice carried out appropriate recruitment checks, and staff received mandatory training appropriate to their roles.

• Staff were aware of current evidence based guidance.
• An overarching governance framework, including regular audit, supported the delivery of the strategy and good quality care. Data from the Quality and Outcomes Framework showed that outcomes for patients with diabetes had improved and were now in line with local and national averages.
• There was a clear leadership structure and staff felt supported by management. The practice had a robust business plan and had recruited staff to meet the needs of its patient population.

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 Drs Swoffer and Hoshyar on 16 June 2016. Overall the practice is rated as requires improvement.

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 for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well managed, with the exception of those relating to the spread of legionella infection and safe recruitment of staff.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Most staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. However, some staff had not received mandatory training in information governance or the application of the Mental Capacity Act.
• Data showed patient outcomes compared well to the national average, with the exception of those for patients with diabetes. The practice had taken steps to address this. Although some audits had been carried out, the programme of audits was limited.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had produced a leaflet which was available in the waiting room to encourage patients who were also a carer to register this with their GP.
• 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.

The areas where the provider must make improvements are:

• Ensure risks to patients are fully assessed and managed, including those relating to legionella infection.
• Ensure recruitment arrangements include all necessary employment checks for all staff.
• Ensure staff complete mandatory training as required for their roles.

• Carry out a full programme of clinical audits and re-audits to improve patient outcomes.

In addition the provider should:

• Ensure there is a robust future business plan with strategies to deal with anticipated increased demand for services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice