Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Smallwood and Partners on 19 November 2015. 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.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

A routine inspection took place in January 2014 which identified that people were not protected from the risk of unsafe management of medicines by making appropriate arrangements for the recording of medicines and for having arrangements for safe administration. This concern was judged to have had a minor impact on people who used the service.

The provider was required to submit a plan detailing the action they were taking and the date at which they would be compliant. The provider told us in their plan that they would be compliant by 21 April 2014.

At this inspection we found that the provider had taken appropriate measures to achieve compliance with this regulation.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

During our inspection we found the service to be welcoming with friendly staff. We saw that on arrival at the service people could speak to reception staff or use the touch in booking screen. People told us staff treated them respectfully and were helpful. One person told us: "The staff are very polite."

People told us that their treatment was clearly explained to them and they were able to ask questions and make choices about their treatment or medication. This enabled people to make informed decisions about their treatment. One person told us, “I am very impressed in how I am included in decisions about my treatment”. Another said, “I am very involved in my treatment”.

We saw that staff spoke politely to people and consultations were carried out in private treatment rooms. Information was clearly displayed for people, including health promotion, access to support services and information about the practice and the services provided.

Care and treatment was delivered in a way that ensured that people’s needs were met. People we spoke with were very positive about their experiences of care and treatment at the practice. Comments made included "It has a chemist on site and is pretty good at meeting your needs" and "I have a very sympathetic GP who is empathetic and sincere".

Policy and procedures were in place for reporting concerns in relation to both adult and child protection issues. Staff had received training in safeguarding children and vulnerable adults. Patients we spoke with confirmed that they were treated well and felt safe.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. One person who used the service told us, “There is sometimes confusion with dispensing medicines”.

Patients said they felt that there were enough staff and that staff had the right skills and experience to meet their needs. One told us that they had received care from ‘professionals’. Another said the staff were very welcoming. They also said, “All aspects of the practice is well equipped with knowledge".

There were formal mechanisms and documentation in place to indicate the practice was able to monitor or assure the quality of the service people received.