We carried out an announced comprehensive inspection at Grand Union Health Centre on 14 March 2019 as part of our inspection programme.

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 rated this practice as good overall and outstanding for providing well led services.

We rated the practice outstanding for providing well led services because the leadership, governance and culture of the practice was used to drive and improve the delivery of high-quality person-centred care. In particular, there was a strong collaborative approach to improving the quality and sustainability of patient care which was demonstrated in the positive clinical outcomes of patients who joined the practice in the September 2018 merger.

In addition, 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.

Whilst we found no breaches of regulations, the provider should:

• Continue to work towards all staff attaining safeguarding children training to a level recommended in updated guidance.
• Consider the infection control lead undertaking enhanced training to support them in this extended role.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grand Union Health Centre on 28 April 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.
• 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.-However, only a small number of patients had been identified as carers to provide them with support.
• 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.

We saw one area of outstanding practice:

The practice supported homeless patients who lived in a hostel next door to the practice, the majority of whom were registered with the practice. They were given same day appointments and the reception team supported them to make GP and hospital appointments, and often collected them from the hostel. The practice also provided them with an outreach service for annual flu vaccinations to care for as many of these patients as possible.

The areas where the provider should make improvement are:

• Monitor improvements to medicines management to ensure systems remain robust.
• Keep under review improvements to the workflow system to ensure pathology results and scanned letters and tasks are completed within stated timescales.
• Ensure relevant clinical audits are completed through the full audit cycle where the improvements made are implemented and monitored.
• Review systems to improve the identification of carers and provide support.
• Update the practice’s policy on notifiable incidents in line with 2014 regulations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice