Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pencester Surgery on 22 July 2015. 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 they found it easy to make an appointment with a named GP 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 clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with seven people who used the service, this included three active members of the Patient Participation Group (PPG), and with clinical and non-clinical staff.

People we spoke with were generally positive about the service. They said that it was not a problem to obtain an appointment. They said that both the clinical and reception staff were friendly and polite. One person told us “The GP I prefer to see is really kind and understanding." Another said “It’s good here and the staff are so helpful to me.” People said that during consultations the doctors explained issues and answered questions in a way they could understand. People told us that they were generally happy with the time allowed for consultations.

People received care that ensured their safety and welfare. People were assessed and care was provided to meet their individual needs. Diagnostic tests were carried out if necessary and appropriately followed up.

There were good infection control practices in place. The service was clean and tidy and people told us the practice was always clean. One person told us “It’s always spotlessly clean, even when the building work was going on; the place was lovely and clean.”

Processes around recruiting and monitoring staff were not robust. Personnel records were incomplete.

The practice monitored the quality of the service by performing audits and seeking the views of the patients by surveys and engagement in the Patient Participation Group (PPG).

This practice is rated as requires improvment overall. (Previous inspection 22 July 2015 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced inspection at Pencester Surgery on 18 April 2018 as part of our inspection programme.

At this inspection we found:

• The practice did not have effective systems to manage risk so that safety incidents were less likely to happen.
• 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.
• Staff involved and treated patients 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.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The GP partners took over another surgery Dover Medical Practice, now known as Pencester Health Centre and most of the staff work across both locations.

We saw one area of outstanding practice:

• The practice collaborated with a local translation service to provide a translator at Pencester Health on a daily basis. Patients had access to the translator who provided telephone or face to face support to patients whose first language was not English. The practice had worked with other organisations to facilitate this service in response to a high need for a translation service within their practice population.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review the reception protocols to include the management of patients with sepsis symptoms.
• Review staff training to help ensure all staff members are up to date with essential training.
• Review how the family of recently bereaved patients are supported.
• Review the complaints system to include verbal complaints in order to help identify trends and change practice.
• Review findings from the GP Patient Survey and take action where necessary to help improve the patient experience.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice