Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingswood Surgery on 9 February 2016. Overall the practice is rated as Good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice registered and managed patients on the violence register who could not be managed at their own practice (including patients who were out of area).

• Feedback from patients about their care was consistently and strongly positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, there was a dedicated care worker from the local women’s aid, who took referrals and offered support to patients suffering domestic abuse. In addition, the local carers support group worked in close collaboration with the practice to identify and support carers.

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

• Collaborative working with the community psychiatric team and drug agencies in the management of vulnerable patient(including substance misuse or homeless patients). Patients could register using the practice address and opportunistic screening, to optimise health and wellbeing, were undertaken when patients presented for other concerns.

• The practice had introduced a child not attending policy to support their child safeguarding protocols and worked collaboratively and openly with the health visiting team, domestic violence team and other external stakeholders in identifying risks and concerns to children.

• The practice had an open and proactive approach to sharing significant events and learning with external stakeholders, to improve patient outcomes.

However, there were areas of practice where the provider should make improvements:

• Ensure all mandatory training is offered to all staff within the specified timescales and to the appropriate level, including future training identified as booked on the day of inspection.

• Ensure their cold chain policy is adhered to and action is taken when breaks in the chain are identified. For example, when vaccine fridge temperatures go out of the recommended range.

• Consider the location of the high risk medicine cupboard with regard to infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingswood Surgery on 14 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall, and good for providing safe, effective, caring responsive and well led services.

We have rated the practice as good for providing effective and responsive care to older people, people with long term conditions, families, children and young people, working age people, those whose circumstances may make them vulnerable and those experiencing poor mental health.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. Leaders had the capacity and skills to deliver high-quality, sustainable care. They had a shared purpose, strived to deliver and motivated staff to succeed.
• Feedback from patients who used the service, those close to them and external stakeholders was continually positive about the way staff cared for patients.
• Staff told us they felt supported and engaged with managers and there was a strong focus on continuous learning and improvement at all levels of the organisation.

Whilst we found no breaches of regulations, the provider should:

• Consider ways to increase the practice recording of patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol/mol or less in the preceding 12 months.
• Continue looking at ways to increase and monitor the uptake on cervical cancer screening and bowel screening.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care