Letter from the Chief Inspector of General Practice

The practice was rated good overall and is now rated good for providing safe services.

We carried out an announced comprehensive inspection of this practice on 26 July 2016. A breach of legal requirements was found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 24 November 2016 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 26 July 2016 we found the following area where the practice must improve:

• Adhere to the national requirements and the practice policy relating to the storage and disposal of controlled drugs.

Our previous report also highlighted the following areas where the practice should improve:

• Ensure all staff receive appropriate training on the Mental Capacity Act 2005.

• Ensure all staff are trained to the appropriate level for safeguarding children.

• Increase the numbers of patients who attend national screening programmes for bowel and breast cancer screening.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 24 November 2016 we found:

• The practice had adequate policies and systems in place to ensure adherence to the national requirements for the storage and disposal of controlled drugs.

We also found in relation to the areas where the practice should improve:

• All staff had appropriate understanding and training in the Mental Capacity Act 2005.

• All staff were trained to the appropriate level for safeguarding children.

• The practice showed us their action plan to increase the number of patients who attend screening programmes for bowel and breast cancer screening. This included putting posters and leaflets in the waiting room. The GPs told us that they now opportunistically reminded eligible patients of the benefits of screening during consultations.

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 Regency Surgery on 26 July 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were not always assessed and well managed for example in relation to storage and disposal of controlled medicines.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. However not all staff had received formal training on the Mental Capacity Act 2005. Not all nursing staff had received the appropriate level of training on safeguarding children.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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 well supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• Over 2% of the patients registered at the practice were human immunodeficiency virus (HIV) positive patients and all of these patients were offered annual reviews. The GPs had received specific training so that they were able to support patients with HIV who were also opiate dependent and prescribe appropriate medicines. A specialist substance misuse nurse visited the practice once every two weeks and worked collaboratively with the practice to maintain the health of this patient group.

The areas where the provider must make improvements are:

• Adhere to the national requirements and the practice policy relating to the storage and disposal of controlled drugs.

The areas where the provider should make improvements are:

• Ensure all staff receive appropriate training on the Mental Capacity Act 2005.

• Ensure all staff are trained to the appropriate level for safeguarding children.

• Increase the numbers of patients who attend national screening programmes for bowel and breast cancer screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Regency Surgery provides primary medical services from Monday to Friday for patients living in central Brighton. The practice is open from 8.30am until 6.30pm Monday to Friday. On Tuesdays the practice remains open until 7pm to accommodate those patients who work. Due to patient feedback the practice remains open during the lunch period. At the time of the inspection the practice had a patient list of just over 4,000.

On the day of the inspection we spoke with 14 patients, five administrative staff members and three members of clinical staff. This included the two GP partners, the practice nurse and the practice manager. We gained the views of the virtual patient participation group (PPG) via e-mail and asked patients for their views through comment cards left at the practice.

Patients we spoke with were complimentary about the service they received and told us they were able to access the service when needed. They described how they felt respected, cared for and were given appropriate information. We saw the results of a recent patient survey which showed patients were pleased with the service they received and would recommend the practice to family and friends.

We saw the practice had links with other healthcare services. For example, we saw links to the mental health service, who provided counsellors to the practice three times a week.

We toured the practice and found the non-clinical and clinical rooms to be clean, tidy and free from clutter. A member of the clinical team was the appointed infection control lead and was responsible for overseeing infection control at the practice. We saw evidence of an infection control audit completed in May 2014.

Staff told us that they found the leadership team approachable and there was an open door culture. We saw that the practice regularly reviewed staff performance at formal annual appraisal meetings. There were regular meetings within the practice where staff were able to voice their views.

We noted that mandatory training for staff was out of date. However this had been recognised by the practice and plans had been put into place to ensure that all staff were able to complete training necessary for their role before the end of the year.