Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Crescent Surgery on 25 May 2017. The overall rating for the practice was Good. However, a breach of regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was identified, and we rated the practice as requires improvement for providing safe services. The full comprehensive inspection report published July 2017 can be found by selecting the ‘all reports’ link for The Crescent Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based follow up inspection, we looked at photos, certificates, audits, minutes of meetings and policies, carried out on 30 January 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 25 May 2017. This report covers our findings in relation to those requirements.

The practice is rated as Good for providing safe services.

Our key findings were as follows:

• The practice assessed the risk of, and preventing, detecting and controlling the spread of infections, including those that are health care associated.

• Staff were following a cleaning schedule.

• Mops and buckets were colour coded.

• Disposable curtains were used in the nurses’ room.

• Orange top sharps bin were used in the GP and nurse rooms, and a poster was displayed in both rooms explaining the difference in colour coded sharp bins.

• An infection control audit had been conducted in November 2017.

• The healthcare assistant had undertaken infection control training.

• A meeting had taken place which discussed key staff members, sharps bins and a cleaning schedule for all staff.

• The service had updated their policy on the storage of medicine.

• The 2017 GP patient survey results for access to appointment showed 89% of patients found it easy to get through on the phone local 72% national 81%. 80% of respondents were satisfied with the surgery's opening hours 74% local 76% national. 86% of patients were able to get an appointment 85% local 84% national. 87% of patients say the last appointment they got was convenient local 81% national 81%.

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 The Crescent Surgery on 25 May 2017. 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 a system in place for reporting and recording significant events.

• The practice had systems to minimise risks to patient safety. However steps were not taken to avoid cross contamination of cleaning equipment, for example mops and buckets were not colour coded. Staff were not following cleaning schedules and fabric curtains were used in the nurses room.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they sometimes found it difficult to get an appointment and there was a lack of continuity of care; however, 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 leadership structure and staff felt supported by management. However not all staff members knew the practice manager. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice won an award from Public Health England in May 2017 for the highest screening rate in Bromley for 16-24 year olds for Chlamydia and Gonorrhea.

The areas where the provider must make improvement are:

• Take appropriate steps to avoid cross contamination of cleaning equipment. Ensuring fabric curtains in the nurse room are removed and replaced with disposable curtains and review cleaning schedule to ensure staff are aware of it and follow it.

The areas where the provider should make improvement are:

• Ensure communication is developed with all staff, ensuring all staff know key responsible staff members.

• Store medicines securely.

• Review patient satisfaction with access to appointments.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice