Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Imperial Surgery on 20 September 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. The practice also recorded learning events and opportunities for shared learning took place at meetings on a monthly basis.
• The vast majority of risks to patients were assessed and well managed. However, we found that there was no current legionella risk assessment in place. The practice responded immediately to rectify this and had a risk assessment in place within 24 hours of the inspection.
• 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.
• The practice had an active patient participation group (PPG) who provided us with examples of how the practice had responded positively to patient feedback.
• The practice had identified 3% of the practice list as carers. Written information was available to direct carers to the various avenues of support available to them. The practice had a carer’s support officer employed by an agency who visited the practice once a month, offering 30 minute support appointments to carer’s.
• 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 consistently scored highly in all areas of the national GP patient survey and had achieved the highest results of any practice in East Devon in the July 2016 national GP patient survey.
• The practice had good facilities and was well equipped to treat patients and meet their needs. The PPG supported the practice by fund raising to provide additional equipment.
• 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.

The areas where the provider should make improvement are:

• To review the legionella risk assessment to ensure it is fully embedded in practice governance processes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We found that Imperial Medical practice was being well run. Patients had a say in the way the services were operated and there were regular checks and audits to ensure the treatment delivered was safe and in line with good practice.

We found that patients were involved in making decisions around their care, based on clear information about the risks and benefits. Staff understood about safeguarding practices to keep patients safe from abusive or abusive practices.

We saw that people's care and treatment was monitored and supported well. Patients told us they had confidence in the staff and that they received good care and support. They also told us they did not find difficulties in arranging appointments when they needed them. Systems were in place to ensure that referrals to other services were dealt with promptly.

Staff told us they received the training and support they needed to carry out their job roles. We saw appraisals were under way to assess and manage staff performance and competency. One patient we spoke with told us “Everyone is really professional, from the nurses and doctors to the receptionists. I have been coming here for years and they are always the same, no matter how much pressure they are under”.