Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingsway Surgery on 7 October 2016. Overall the practice is rated as good but requires improvement for providing safe services.

Our key findings across all the areas we inspected were as follows:

• The practice was in a converted residential property and the provider was aware of the limitations of the premises. Although clinical areas were reasonably acceptable, work could be done to improve the premises in terms of basic décor and decluttering of the premises to make the environment safer.
• There were some systems in place to mitigate safety risks including analysing significant events and safeguarding. The practice had a defibrillator for treatment of some medical emergencies but no oxygen. This was purchased after our inspection.

• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).
• Patients’ needs were assessed and care was planned and delivered in line with current legislation.
• 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. The practice sought patient views about improvements that could be made to the service; including having a patient participation group (PPG) and acted, where possible, on feedback.
• Staff worked well together as a team and all felt supported to carry out their roles.

There were examples of outstanding practice. These included:

• The practice manager had audited the attendances of patients experiencing poor mental health and with learning disabilities. As the practice did not have the benefit of external agencies regularly attending, the practice and the patient participation group set up an informal group to support patients.
• The practice recognised preferences of elderly patients, not wanting to attend later in the day, especially in the winter months when it is darker. The practice had spread the appointments across the day making appointments accessible in the early afternoons.

• The practice manager had met with all staff to discuss their career progression in the form of a five year strategic plan.

However, the provider should:

• Address the backlog of letters from other clinics to be scanned on to patient records and ensure there is one system in place that all staff work from.

• Increase the monitoring of the cleanliness and safety of the premises and remove excess clutter from non-patient areas within the building to reduce fire hazards and promote a better working environment for staff.

• Monitor complaints in order to ensure patients are given a timely response, and where there are foreseeable delays, issue a holding letter to the patient to explain the reason for the delay.

• Carry out performance appraisals for the healthcare assistant even though they receive these from their other employer.

• Have an overview of all training completed by clinicians to ensure everyone is up to date with their mandatory training.

• Periodically review all complaints and significant events with the staff team to identify any trends.

• Monitor the storage of blank prescription pads used for home visits.

• Consider holding regular staff meetings for the whole team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with four patients during our inspection and invited them to share with us their experience and views of Kingsway Surgery. Feedback about the surgery was positive. Patients said it was easy to secure an appointment and they rarely had to wait for too long beyond their appointment time.

Patients told us they understood their condition and treatment options because the GP or healthcare professional explained things in a way they understood. One patient said, “I ask a lot of things but the doctor is patient and explains things well.” Another patient said, “At this surgery, the doctors spend time explaining things so they are sure you understand.”

The patients we spoke with all said that they could book an appointment with their preferred GP most of the time. Patients also confirmed that they were referred to other services or healthcare professionals by the GP in a timely way, and received appointments promptly.

Medical records and other records containing confidential information were stored securely.

There were effective systems in place to monitor the safety and quality of the service.

Staff were receiving on-going training in relation to their professional development. In addition, arrangements were in place for staff to undertake mandatory (required) training. A process was in place to ensure staff received an annual performance appraisal.