Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Peter Street Surgery on 17 June 2015. Breaches of the legal requirements were found. Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches.

We undertook this focussed inspection on 21 July 2016, to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Peter Street Surgery on our website at www.cqc.org.uk.

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 Peter Street Surgery on 17 June 2015. Overall the practice is rated as good.

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

It required improvement for providing safe services.

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

• Although staff raised concerns and reported incidents and near misses. We found that some significant events were not being reported because not all staff either knew about the policy for reporting events or fully understood it. Events that were recorded were monitored, appropriately reviewed and addressed.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example working alongside a local supplier to provide audiology services and providing non- obstetric ultrasound, physiotherapy and family planning services for their own patients and those from other practices.

• 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 training 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 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.

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

Importantly the provider must:

• Ensure a systematic approach to reporting, recording and monitoring significant events, incidents and accidents.
• Ensure audits of practice are undertaken, including completed clinical audit cycles.

Additionally the provider should

• Ensure that curtains and the waiting room carpet arer cleaned in accordance with the cleaning schedules.
• Ensure that all staff understand the chaperone policy and that all staff who act as chaperones have the risks of their acting as chaperones assessed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice