Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingsthorpe Medical Centre on 03 November 2015. 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 a system was in place for reporting and recording significant events.

• Risks to patients were generally assessed and appropriately managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.

• Information about services and how to complain was available and easy to understand.

• Patients said access to appointments was generally good and that 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 leadership structure in place 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 must make improvement are:

• The practice must ensure that staff who chaperone are trained to undertake this duty and have been risk assessed for the need to have a DBS check.

• The practice must review policies and procedures for the provision of locums, to ensure that records are up to date with GP registrations and DBS checks.

The areas where the provider should make improvement are;

• To review infection prevention and control arrangements to take into account the Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating November 2015– Overall Good with safe rated Requires Improvement)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection at Kingsthorpe Medical Centre on 25 October 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• 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.
• Clinical performance data was comparable to the national and local data.
• Patients we spoke with told us staff had treated them with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• While the practice had appropriate policies and procedures we found these had not been applied consistently such as for staff recruitment and to risk assess substances hazardous to health, or to ensure the availability of cleaning schedules to assure appropriate cleaning.
• At the time of our inspection the practice was completing the checks of immunisation status of applicable clinical and non- clinical staff in relation to immunisations recommended by the Health and Safety at Work Act 1974 and was liaising with the local occupational health service provider.
• Results from the national GP survey showed the practice was rated lower than local and national averages for some questions relating to care and treatment. The practice was aware of this and was acting to make improvements. Although not directly comparable, a local practice survey indicated an improvement in patient satisfaction with the treatment and service received.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. For example, the practice was an accredited primary care research site for the national institute for health research. Currently the practice was participating in three research projects to improve health outcomes for patients.

The areas where the provider must make improvements are:

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the requirement notice at the end of this report for details).

The areas where the provider should make improvements are:

• Develop systems to increase childhood immunisations uptake to meet the target percentage of 90% in all four indicators.
• Review and improve the process for exception reporting for QOF (Quality and Outcome Framework) for clinical care.
• Continue to improve national GP patient survey results and patient feedback, particularly in relation to involvement in decisions about care and treatment.
• Develop the appraisal system for nurses to include discussions about career development and training needs.
• Develop a system to engage the patient to encourage them to come forward if they have communication or information needs due to a disability or sensory loss (as required by the Accessible Information Standard).