Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Dickie, Pontefract & Saksena Joye (also known as The Reddish Family Practice) at 306 Gorton Road, Stockport, SK5 6RN and at their branch surgery located at South Reddish Medical Centre, Stockport, SK5 7QU on 11 November 2016. This report covers our findings from both premises. The two practices were previously separate organisations. Therefore data in this report refers to the individual practices.

Overall the practice is rated as good.

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

• The main practice is situated in purpose built premises with a ramp for disabled access, translation services and hearing loops. However, disabled patients would require assistance with the second door to the main site as there was no means of calling for assistance other than relying on the possibility of receptionists being able to see them. The branch surgery was a converted house and had no lowered kerb for disabled access.
• The practice had undergone an organisational change with the merger of the two practices and had taken on a further 1,800 patients from other nearby practices.
• The practice had recently changed its computer systems. The practice had identified a data glitch in the transfer of data from the old system to the new one causing incorrect dates of medication reviews on the new system. The practice had notified the IT suppliers as soon as this issue had been identified; however there had been no resolution of this issue on the date of our inspection. The practice had discussed the problem at a practice meeting and put contingency plans in place to make sure GPs checked the records before signing the prescription. Although we appreciated that the transfer of data was not fully within the practice’s control, we were concerned that the contingency plans were not routinely followed. We also found that practice protocols in place for the management of uncollected prescriptions were not being adhered to. Issues we identified were discussed in practice meetings immediately after our inspection and appropriate steps were taken to mitigate any risks.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Learning from incidents took place to prevent reoccurrence.
• Appropriate health and safety risk assessments for the premises were carried out, however, actions necessary for the most serious risks identified within the electrical installation assessment (January 2016) for the main site premises had not been completed. This was addressed immediately after our inspection.
• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment). The practice published its duty of candour policy on the practice website and it was available in the waiting room.
• 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. The practice sought patient views about improvements that could be made to the service; including having a virtual patient participation group (PPG) and carrying out a variety of patient surveys and acted, where possible, on feedback. For example, satisfaction with the telephone system to make appointments had previously been low and the practice was working on installing a new system.
• Staff worked well together as a team and all felt supported to carry out their roles.

There were elements of outstanding practice:

• There was an open and transparent approach to safety. For example, the practice published its infection control audit results on the practice website.
• All staff members were invited to comment on colleagues’ performance and this feedback was used at individual appraisals.
• Staff meetings opened with discussion about positive thoughts about the practice and staff were encouraged to identify improvements and supported in innovation. For example, there were monthly nursing team meetings and the development of protocols for the nursing areas. These included-contact telephone numbers for each vaccine manufacturer displayed on the fridge for ease of contact; use of stickers displaying the words ’I am clean’ on medical equipment so staff reassured ready for use; stickers on waste containers reminding clinicians to ‘stop and think’ that they were using the correct disposal procedure before they discarded waste (this system had been adopted by the local infection control team).
• The practice had a comprehensive induction welcome pack for staff which included photographs of staff members, building plans as well as details of operational delivery and safety issues.
• The practice had produced a patient information leaflet about keeping young children safe from abuse.

The provider also should:-

• Add additional information to their complaints procedure and patient information leaflet about who patients can complain to if they do not wish to complain to the practice.
• Consider fire proof storage for paper medical records at the branch site.
• Include details of health and safety representatives on the Health and Safety poster for staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

When we visited the Family Surgery we talked to five patients three of whom were visiting the doctors on the day of our visit. They told us that they were satisfied with the care and treatment they received from the surgery. One patient said “It’s a good practice. The staff on reception are really friendly and I have no complaints”. Another patient told us “I’ve no complaints at all – I think the practice runs very well”.

We did not directly observe treatment during this inspection. We spent time with reception and office staff as well the health care assistant and nursing staff. We talked to the practice manager as well as to one of the doctors who is a partner in the practice. We looked at the arrangements for safeguarding patients from abuse and found that the practice had put arrangements in place to ensure that they met the requirements for this.

During our inspection we looked around the building and at the facilities available there and found this satisfactory. We looked at the systems for holding information about patients and their care and found that these supported the doctors and staff to provide a safe service. We checked the arrangements for recruitment of staff and saw that these meant that applicants for employment were checked for suitability before working at the practice.

We reviewed the information available to us about Drs Dickie, Pontefract & Saksena Joye on 15 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.