Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Morris House Group Practice on 19 January 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 an effective system 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Data from the Quality and Outcomes Framework showed that patient outcomes for most indicators were comparable to the local and national averages. However, the Clinical Exception Reporting rate was above the local and national average.
• Patients said they were treated with compassion, dignity and respect and felt involved in decisions about their care and 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.
• The GP patient survey results showed that patient’s satisfaction with regards to booking appointments was below the local and national average. Patients said they often found it difficult to make an appointment with a GP and had difficulty getting through to the surgery by telephone.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had identified only 51patients as carers (0.4% of the practice list).
• There was a clear leadership structure and staff felt supported by management.
• The practice sought feedback from staff and patients, which it acted on. However, there was no active patient participation group.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• The provider should continue to monitor patient satisfaction rates regarding booking routine and urgent appointments and implement improvements as appropriate.
• The provider should continue to develop and implement a clinical quality improvement programme aimed at reducing the exception reporting rate for the Quality and Outcomes Framework (QOF).
• The provider should record batch numbers of blank electronic prescriptions placed in individual printers and maintain records when prescription pads are assigned to individual GPs.
• The provider should consider proactive strategies to encourage patients to join a patient participation group (PPG) and establish regular communication with group members.
• The provider should review how patients with caring responsibilities are identified and recorded on the clinical system to ensure that information, advice and support is made available to all carers registered with the practice.

Professor Steve Field CBE FRCP FFPH FRCG 

Chief Inspector of General Practice

When we inspected on 29 January 2014, we noted that information about making a complaint was not available at the practice. This information was also difficult to locate on the practice website and meant that the provider was failing to comply with the requirements of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We asked the provider to take action.

Following our inspection the practice sent us an action plan setting out how it intended to meet the requirements of the regulation. At this inspection, we saw that details of the complaints procedure were displayed in reception and also shown on the reception TV system. We found that the action taken by the practice was sufficient to comply with the requirements of the regulation.

We also looked at the practice’s system for referring patients to other healthcare professionals as we had received a concern that in some cases referrals had been delayed. At our inspection we found that systems were in place to process patient referrals on a timely basis.

We spoke with six patients and the practice manager. We also observed staff communication with patients and checked three patients’ records.

All the patients we spoke with were satisfied with the way the doctors treated them. However, some patients were not happy with their interaction with some receptionist staff. For example, one patient said, "The receptionist here are pointless. They take no time [to explain or listen to patients]”. Patients were also not happy with the appointment system. However, the practice manager indicated that the practice was working to address this by employing an additional doctor.

We noted that the general practice had a safeguarding policy and staff had attended training on safeguarding. Patients felt that their privacy and dignity was respected. However, information about making a complaint was not available to patients.