Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Dr Ross and Partners practice on 23 March 2016.

During our previous inspection of the practice in July 2016 we had identified concerns relating to infection prevention and control and in the management of risks to the health, safety and welfare of service users. The practice was issued with two requirement notices for breaches in regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The practice was rated Good overall with a requires improvement rating for providing safe services.

This inspection was to review the actions taken by the provider to meet regulatory requirements where we had previously identified breaches. For this reason we have only rated the location for the key questions to which the regulations relate, are services safe? The report should be read in conjunction with the full inspection report published in September 2015.

At this inspection we found the practice had made improvements since their previous inspection in July 2015 and was meeting the regulations that had previously been breached.

Specifically we found:

• Arrangements to help manage and minimise the risks relating to infection prevention and control had been reviewed and systems put in place to help keep patients safe.
• Recruitment arrangements included all necessary risk assessments and employment checks for staff.
• Risks in relation to the premises, including fire safety were being appropriately managed.

In addition the practice continued to demonstrate good practice in the following areas:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Changes to the practices current reporting systems demonstrated appropriate increases in reporting which they used as opportunities to learn and develop good practice within the team.
• Robust arrangements were in place to help keep patients at safe in relation to medicine management and .in an emergency.

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 Dr Ross and partners on 1 July 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 the six population groups (older people, 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:

• At the time of our inspection the practice was going through a period of transition. Management arrangements which had formerly been shared with another practice in Northfield Health Centre were being separated and new management was in place.
• 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.
• Processes in place for managing risks were not robust, we highlighted risks associated with infection control, recruitment and the premises that needed to be addressed.
• 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 and urgent appointments were 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

The areas where the provider must make improvements are:

• Ensure robust arrangements are in place for identifying, assessing and managing risks to patients including those relating to recruitment, and the premises.
• Ensure risks associated with infection prevention and control are appropriately managed to minimise the risk of cross infection.

In addition the provider should:

• Ensure staff are clear about the purpose and requirements of a chaperone to ensure adequate safeguards for staff and patients during an examination.
• Review systems for maintaining patient confidentiality at reception.
• Review contact information available to patients on the practice website to ensure it remains up to date for example, links for carers support.
• A system should be in place to ensure correspondence is handled appropriately when a patient with no fixed abode registers under temporary addresses.
• Review systems in place to ensure staff have read and understood practice policies and procedures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice