Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Kenyon and Partners on 27 August 2015. This inspection covered areas of concern we identified at our last inspection in July 2014 regarding cleanliness and maintenance of the premises as well as identifying and responding to risk. We found the practice had addressed these concerns.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Staff recruitment, training and support ensured they were safe and able to fulfil their roles.
• 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.
• The practice was clean and well maintained.
• There was monitoring of patient care but this was not in the form of a programme of clinical audit including repetition and completion of audits to ensure improvements to the service were made.
• Some data regarding medicine reviews suggested clinical assurance could be improved.
• 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.
• 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 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.

We saw several areas of outstanding practice including:

• Nurse support was supplemented with six weekly clinical supervision sessions led by an external clinical facilitator. This provided additional support beyond the regular training and supervision for nurses in this practice.
• It was policy for a patient’s who were reaching the end of their life and choosing to die at home to have their GP provide a family or carer with a personal contact number so that contact out of hours could be made if necessary.

Additionally there was one area the practice should make improvements:

• Monitor data related to medication reviews to ensure that patients who require medications reviews receive these.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Dr Kenyon and partners (locally known as 19 Beaumont Street) is a General Medical Practice situated in central Oxford. Over 13,000 patients are registered with the practice. The practice provides a range of services for patients which includes clinics for the management of long term conditions, family planning, travel clinic and child health clinics. Patients are signposted to and supported by other health care professionals who visit the practice and by local voluntary groups.

We spoke with 18 patients during our inspection. Patients we spoke with were complimentary about the care and support they received from the GPs and staff at the practice. However, a few of the patients we spoke with told us that they found the practice premises difficult to use because of the layout. We looked at the results of the last practice survey. This showed us that patients were consistently pleased with the service they received.

The practice is a member of the Oxfordshire Clinical Commissioning Group (CCG) and is in the Oxford City locality. A GP and the practice manager attend CCG meetings. One of the GPs is a member of a group assessing the opportunity to commission health and social care services specific to the population of the locality. The practice is also accredited to carry out training of GP trainees.

Procedures to safeguard vulnerable patients are in place. However, systems to monitor cleanliness and reduce the risk of cross infection require improvement. The practice is effective because current guidelines in care and treatment are followed. Audits to review quality of care are carried out. The practice demonstrates a commitment to caring for their patients. The interactions we observed during our inspection were polite and respectful. Services are responsive. A range of appointment options are available and referrals to specialist services are made promptly. The practice is well led. GPs have clear areas of responsibility and patient data is used and stored appropriately.

Clinical data showed us the practice performed well in delivering care and treatment for patients with long term conditions. The needs of working age patients are recognised. A range of appointment times are available and telephone consultations could be offered. Mothers, babies and young children receive services including childhood immunisation clinics and mother and baby health checks. We spoke with some elderly patients they told us they received care and support from the GPs that met their needs. The practice hosted a Citizens Advice Bureau (CAB) benefits advisor to assist patients on low incomes with benefits advice. The GPs referred patients for counselling when appropriate.

We found that the practice was not meeting one of the regulations to reduce the risk of cross infection by operating systems in regard to cleanliness and infection control. We have asked the practice to send us a report, setting out the action they will take to meet these safety standards. We will check to make sure that action is taken.

Services are provided from:

19 Beaumont Street, Oxford, Oxfordshire, OX1 2NA