Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Harewood Medical Practice on 16 May 2017. The overall rating for the practice was good with the well led domain rated as requires improvement. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for Harewood Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 15 August 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 May 2017. 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 taken steps to monitor and oversee that staff received appropriate training and updates as was necessary to enable them to carry out the duties they were employed to perform. They provided evidence of this.

• Annual staff appraisals had been implemented. Staff appraisals for all non-clinical staff and practice nurses had been completed and we saw evidence of this. Appraisals for Advanced Nurse Practitioners and salaried GPs were in the process of being arranged.

• Policies and procedures had been updated and reviewed where necessary. This included the Medication Review Protocol and the Staff Handbook. The practice had not recruited any new staff members since the inspection in May but were clear about the required recruitment checks for new staff.

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 Harewood Medical Practice on 5 October 2016. The overall rating for the practice was requires improvement with one of the key questions, that of safe, rated as inadequate. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Harewood Medical Practice on our website at www.cqc.org.uk.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups, it will be re-inspected no longer than six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

This inspection was undertaken following the period of six months following publication of the report and was an announced comprehensive inspection on 16 May 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• The practice had defined systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. However on the day of the inspection we found that some staff had not received training updates to provide them with the skills and knowledge to deliver effective care and treatment. The practice rectified this following the inspection and we received evidence that all staff were up to date with essential training.

• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• The practice provided support to veterans and families of armed forces personnel at Catterick Garrison.

• Some patients we spoke with said they found it difficult to make an appointment with a GP. The practice had recognised this and had an action plan in place to address it.

• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

Take steps to monitor and oversee that staff receive appropriate training and updates as is necessary to enable them to carry out the duties they are employed to perform.

Implement annual staff appraisals.

Adhere to the guidance supplied in their recruitment policy with regard to recruitment checks for new staff.

Regularly update and review policies and procedures.

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 Harewood Medical Practice on 16 May 2017. The overall rating for the practice was good with the well led domain rated as requires improvement. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for Harewood Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 15 August 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 May 2017. 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 taken steps to monitor and oversee that staff received appropriate training and updates as was necessary to enable them to carry out the duties they were employed to perform. They provided evidence of this.

• Annual staff appraisals had been implemented. Staff appraisals for all non-clinical staff and practice nurses had been completed and we saw evidence of this. Appraisals for Advanced Nurse Practitioners and salaried GPs were in the process of being arranged.

• Policies and procedures had been updated and reviewed where necessary. This included the Medication Review Protocol and the Staff Handbook. The practice had not recruited any new staff members since the inspection in May but were clear about the required recruitment checks for new staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During the inspection of this practice, we spoke with one doctor who worked at the practice, the practice manager, and a selection of other staff such as nurses and receptionists.

We talked to some patients and asked about their experiences when visiting the practice. They told us they were satisfied with the care, support and advice they had received. One patient said “The practice staff are excellent everything is good”. And “I have been poorly recently and the care and attention I have received has been wonderful”.

We observed the experiences of patients who used the service. We saw that staff interacted and communicated well with people. When we looked around the practice we found that it was clean and tidy.

We found that patients were safeguarded against the risk of abuse.

We saw that effective systems were in place to deal with any complaints made about the practice.

The practice was compliant in all of the outcome areas we looked at during this inspection.