We carried out an announced comprehensive inspection at Third Floor Lanark Road Medical Centre on 29 January 2019 as part of our inspection programme.

At the last inspection on 17 January 2018 we rated the practice as requires improvement for providing well-led services because the provider had failed to:

• Ensure appropriate recruitment checks were undertaken in line with guidance.
• Ensure that all staff were aware of the procedure for reporting significant events and that all incidents were recorded and investigated.
• Maintain up-to-date records relating to facilities management, specifically remedial work identified from risk assessments to satisfy itself that the areas managed were compliant.
• Develop a written business plan and strategy in line with health and social priorities to meet the needs of its practice population.

At this inspection, we found that the provider had satisfactorily addressed these areas.

We have rated this practice as good overall and good for all population groups.

We based our judgement of the quality of care at this service is on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice had addressed the findings of our previous inspection.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to improve the uptake of child immunisations and cervical screening.
• Continue with efforts to encourage and record patients who have identified as carers.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. The practice was previously inspected on 27 November 2014 and rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Third Floor Lanark Road Medical Centre on 17 January 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• There was an effective system to manage infection prevention and control.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Results of the national GP patient survey and comment cards we received showed patients felt they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Although there were systems and processes in place to support good governance we found that this was inconsistent in respect of safe recruitment, recording and investigating of significant events and incidents and oversight of facilities management provided by NHS Property Services.
• The practice team told us their aim was to provide high quality care and good patient outcomes. However, there was no supporting written strategy or business plan to support this.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Consider the infection control lead undertaking enhanced training to support them in this extended role.
• Review the NICE Guidelines NG51: Sepsis Recognition, Diagnosis and Early Management to ensure the practice can appropriately assess all patients, including children, with suspected sepsis.
• Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to them.
• Consider how patients with a hearing impairment would access the service.
• Continue to actively promote patients to join the Patient Participation Group to enable patients to have a say in the way services are delivered to best meet their needs, and the needs of the local community.

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 Third Floor Lanark Road Medical Centre on 27 November 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, 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; people whose circumstances may make them vulnerable; and people experiencing poor mental health.

Our key findings across all the areas we inspected were as follows:

• 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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Patients said they were treated with 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 access the service, with urgent appointments available the same day and a weekend walk-in clinic.
• There was a clear leadership structure and staff felt supported by management.

We saw one area of outstanding practice:

• The practice was responsive to the needs of their population, which resulted in better outcomes for their patients. The practice’s patient population consisted of a high proportion of Middle Eastern patients who spoke Arabic and did not have English as a first language. Even though two of the GPs spoke Arabic, the practice had employed an interpreter to attend the practice every weekday to assist these patients with written and verbal communication.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure availability of an automated external defibrillator (AED) or undertake a risk assessment if a decision is made to not have an AED on-site.

Importantly, the provider should:

• Formalise their vision and values and share these with patients and staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice