We carried out an announced comprehensive inspection at The Loxford Practice on 29 March 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the March 2017 inspection can be found by selecting the ‘all reports’ link for The Loxford Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 March 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 29 March 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Staff treated patients with kindness, respect and dignity.
• The practice had made efforts to establish a carers register. The practice now identified over 1% of their registered patients as being carers.
• Results from the National GP Patient Survey showed the practice scored lower than local and national averages for patient satisfaction regarding access to the practice.

There are areas of practice where the provider should make improvements.

• Continue to engage with patients regarding easier access to the practice by telephone
• Review the sevice and care provided by the nursing team in relation to low patient satisfaction scores

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 Practice Loxford on 6 November 2015. The overall rating for the practice was Inadequate. The specific key questions were rated as follows: Safe-Requires Improvement, Effective-Good, Caring-Requires Improvement, Responsive-Inadequate and Well-Led-Inadequate. We identified a number of areas where the provider needed to make improvements. As a result of the overall rating, the practice was placed in special measures for a period of six months. The full comprehensive report on the November 2015 inspection can be found by selecting the ‘all reports’ link for The Practice Loxford on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 29 March 2017. A new provider for the provision of services at this location was commissioned by NHS England to provide services from August 2016. The new provider AT Medics Limited currently provides services at a number of practices within London. As a result of this inspection, the practice is now rated as requires improvement overall.

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.
• Patient concerns regarding access to the practice via telephone had been addressed through the installation of a new telephone system appropriate to the needs of the practice. The new telephone system was installed by the new providers following feedback from patients and staff regarding the telephone system installed earlier in June 2016. However, responses from the most recently published National GP Patient Survey revealed patients still have difficultly accessing the practice by telephone.
• 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.
• Improvements had been made to the patient waiting area. New furniture and patient information boards had been installed.In addition, new patient check-in systems and a Jayex information board have been installed at the practice.
• 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.
• Telephone consultations were available to patients who were unable to attend the surgery during normal opening hours and for those who could not attend the practice.
• The practice had started to engage with the local community through the hosting of a practice open day and engaging in consultations with certain sections of their patient list to promote healthier lifestyles through talks hosted at the practice.
• The practice 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.

The areas of practice where the provider should make improvements are:-

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.
• Conduct regular reviews of practice patient register to ensure information contained in records is accurate.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice