Letter from the Chief Inspector of General Practice

We carried out a focussed inspection visit of the Temple Fortune Health Centre on 22 March 2017. We found the practice to be good for providing safe services and it is rated as good overall.

We had previously conducted an announced comprehensive inspection of the practice on 13 January 2016. As a result of our findings during that visit, the practice was rated as good for being effective, caring, responsive and well-led, and requires improvement for providing a safe service, which resulted in a rating of good overall. We found that the provider had breached one regulation of the Health and Social Care Act 2008: Regulation 18 (2) (a) staffing. You can read the report from our last comprehensive inspection http://www.cqc.org.uk/location/1-1269890921/reports. The practice wrote to us to tell us what it would do to make improvements and meet the legal requirements.

We undertook a focussed inspection visit on 22 March 2017 to check that the practice had implemented its plan, and to confirm that it had met the legal requirements. This report only covers our findings in relation to those areas where requirements had not been met previously.

Our key findings on 22 March 2017 were as follows:

• All staff had received safeguarding training to the appropriate level.

• The infection control lead had received appropriate training.

• The practice now had access to an automated external defibrillator (AED) and staff had been trained in its use.

The practice had implemented other changes relating to the caring and well-led domains –

• The practice had improved the systems to identify and support carers and had increased the number of identified carers.

• Clear terms of reference for the patient participation group (PPG) had been developed which included a written constitution for the group.

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 Temple Fortune Medical Centre on 13 January 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 assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw two areas of outstanding practice:

• Palliative patients (those nearing the end of their lives), and their carers, were given access to their GP’s private mobile number to use at any point during a 24 hour period should they need to raise concerns or discuss aspects of care and treatment. This was particularly helpful for the practice’s Jewish population as religious custom dictates that when a patient passes away burial should take place without undue delays.

• The practice offers in house counselling and psychotherapy to support vulnerable patients including refugees or migrants presenting with post traumatic stress disorder, and also refer

  these and

  Farsi speaking patients to the

  community mental health service

  operated in house by Barnet Clinical Commissioning Group (CCG).This service is known as CANDI and is commissioned from Camden and Islington community mental health service.

The areas where the provider must make improvement are:

• Ensure all clinicians are trained in safeguarding adults and children to the required level 3.

• Ensure all non clinical staff are trained in safeguarding children to the required level 1.

The areas where the provider should make improvement are:

• Ensure that the IPC (Infection, prevention and control) lead receives training for this role in accordance with published guidelines and that IPC training is cascaded to clinical and non clinical staff.

• Ensure that practice staff have access to a defibrillator ) in line with UK resuscitation guidelines. (An automated external defibrillator (AED) is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can stop an irregular heart rhythm and allow a normal rhythm to resume following sudden cardiac arrest. Sudden cardiac arrest is an abrupt loss of heart function).

• Improve systems to identify and support carers in line with published guidelines.

• Develop a clear terms of reference for the newly merged patient participation group (PPG)

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice