This practice is rated as Requires Improvement overall. (Previous inspection August 2016 – Requires Improvement)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Requires Improvement

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 – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those recently retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

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

We previously inspected Dr Samuel Levenson at a previous location on 11 August 2016. At this inspection the service was rated as requires improvement. Since this inspection the provider had moved into a new purpose built location. We carried out an announced comprehensive inspection at Dr Samuel Levenson on 9 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had made improvements since their last inspection in particular around safety processes and governance within the practice. However, there were still further improvements needed.
• The practice had some systems to manage risk so that safety incidents were less likely to happen but some improvements were still needed. When incidents did happen, the practice learned from them and improved their processes but incidents were not always discussed at team meetings.
• 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 and treated patients with compassion, kindness, dignity and respect.
• Staff did not always receive the training or supervision required in order to carry out their role.
• The practice was underperforming in the Quality Outcome Framework results.
• Patients did not find the appointment system easy to use and reported that they often had long waits to be seen by the doctor.
• There was a strong focus on improving within the practice and the practice had acknowledged there were still improvements to be made in order to become compliant with the regulations.

The areas where the provider must make improvements are:

• Persons employed by the service must receive appropriate training and supervision.
• Ensure systems or processes are established and operated effectively to ensure good governance of the service.

The areas where the provider should make improvements are:

• The practice should review patient feedback relating to waiting times and access.
• The practice should review their QOF scores.
• The practice should attend local neighbourhood safeguarding meetings.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Samuel Levenson on 15 January 2019 as part of our inspection programme.

At the last comprehensive inspection in March 2018 we rated the practice as good for the key questions caring; and requires improvement for safe, effective, responsive and well led. The overall rating was requires improvement. This was because:

• The practice had not established effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• The practice had not ensured that persons employed by the service received appropriate training and supervision.

At this inspection, we found that the provider had satisfactorily addressed these areas.

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected
• Information from our ongoing monitoring of data about services and
• Information from the provider, patients, the public and other organisations.

We have now rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was well-led and managed the delivery of high-quality, person-centre care.

The areas where the provider should make improvements are:

• The practice should consider the need to have the fire alarms tested at the same time each month.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice