Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 28 April 2015. A breach of legal requirements was found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet regulatory requirements in relation to;

• Regulation 17 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 – Good governance

We undertook a desk based focused inspection for Dr J D Sleath and Dr R G Warner’s practice on 5 October 2016 to check that they had followed their plan and to confirm that they now met regulatory requirements. This report only covers our findings in relation to those requirements. The report from our last comprehensive inspection can be seen by selecting 'all reports' link for Dr J D Sleath and Dr R G Warner on our website at www.cqc.org.uk. Overall the practice is rated as good.

Following our inspection on 28 April 2015, the practice were told they must:

• Establish an effective system to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors. This must include regular audits of infection prevention and control, arrangements for calibrating equipment used for patient care and a review of policies and procedures to ensure they reflect current legislation and national guidance.

We found that on 5 October 2016 the practice now had improved systems in place.

• The practice had updated practice-specific policies and procedures to support practice and reduce risks associated with infection prevention and control, calibrating equipment and portable appliance testing, and emergency medicines. They had updated policies relating to recruitment, equality and diversity, clinical waste management, consent and chaperones.

• The practice had addressed the areas where we suggested they should make improvements and introduced a system to record that the GP bags were checked to ensure that medicines were correct and in date. They had also introduced a checking system to record the serial numbers of prescriptions and included portable appliance testing as part of the annual equipment calibration checks which had been implemented.

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 Dr J Sleath and Dr R Warner (Kingstone Surgery) on 28 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, responsive and well led services. It was outstanding for providing caring services. The practice was good for providing services to older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), those experiencing poor mental health or living with dementia and people whose circumstances may make them vulnerable. The practice required improvement for providing safe services.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Patients’ needs were assessed and the practice planned and delivered care following best practice guidance.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had an established and well trained team with expertise and experience in a range of health conditions.
• Patients described the practice as caring, professional and competent. They commented on the availability of appointments, being cared for promptly, the GPs’ human touch and the warm relaxed atmosphere.
• People valued having a local GP practice and the service it provided. We were told that the practice was a cornerstone of the community.
• Information about services and how to complain was available and easy to understand. The practice responded to complaints in a positive way.
• The practice communicated with patients and acted on feedback to improve the service they provided.

We saw several areas of outstanding practice including:

• The practice had a strongly embedded focus on providing a caring service based on individual need and prided itself on the quality of relationships it built with patients. The impact of this was reflected in very positive patient feedback about the care and compassion they were shown.
• The practice provided very good flexibility of access to appointments. Patients could book appointments up to six months in advance and on the day. There was an open surgery every day which patients could attend without an appointment. The practice provided two morning surgeries a week between 7 and 8am and would see patients outside core surgery hours in certain circumstances. The GPs were committed to seeing patients on the same day if they wanted or needed this. The impact of this provision was reflected in very positive patient feedback about their ability to get appointments.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Establish an effective system to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors. This must include regular audits of infection prevention and control, arrangements for calibrating equipment used for patient care and a review of policies and procedures to ensure they reflect current legislation and national guidance.

In addition the provider should:

• Establish records to confirm that the contents of GPs’ bags are regularly checked.
• Establish records of blank prescriptions in line with guidance from NHS Protect.
• Ensure that the competence of staff completing portable appliance checks meets the expectations in guidance from the Health and Safety Executive.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice