Archived: Dr Eric Paul

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection February 2017 – Requires Improvement)

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? – Good

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 undertook a comprehensive inspection of Dr Eric Paul on 6 January 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The practice was rated as requires improvement for providing safe, effective, caring and well led services and good for providing responsive services. Overall the practice was rated as requires improvement and Requirement Notices were issued in respect of breaches in:

1. Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment;

2. Regulation 17 HSCA (RA) Regulations 2014 Good governance;

3. Regulation 18 HSCA (RA) Regulations 2014 Staffing.

The full comprehensive report following the inspection in January 2017 can be found by selecting the ‘all reports’ link for Dr Eric Paul on our website at www.cqc.org.uk.

We undertook a comprehensive inspection of Dr Eric Paul on 1 December 2017 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.

During our visit we:

• Spoke with a range of staff including the principal GP, Practice Nurse, Practice Manager and reception staff and spoke with patients who used the service.
• Observed how patients were being cared for in the reception area.
• Reviewed a sample of the personal care or treatment records of patients.
• Reviewed comment cards where patients and members of the public shared their views and experiences of the service.
• Looked at information the practice used to deliver care and treatment plans.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• 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.
• Clinical audit had a positive impact on quality of care and outcomes for patients.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Ensure that infection prevention control audits are completed annually.

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 Dr Eric Paul on 6 January 2017. Overall the practice is rated as requires improvement.

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

• There was a system in place for reporting and recording significant events.
• Systems were in place to keep people safe however shortfalls were identified including those relating to chaperoning, safeguarding and the monitoring of high risk medicines.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had most of the skills, knowledge and experience to deliver effective care and treatment however there were shortfalls in mandatory training including safeguarding, basic life support and infection control.
• There was limited evidence of appraisals and personal development plans for staff.
• Patient outcomes were below average when compared to the national average.
• Clinical audit was not used to drive improvements in patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• There was no system in place to identify and support patients who were also carers.
• 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 there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was 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 patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Ensure staff are appropriately trained in safeguarding, chaperoning, infection control and basic life support and ensure appraisals are completed and documented for all staff.
• Assess the risk of non-clinical staff not being DBS checked when undertaking chaperone duties.
• Implement a policy for the handling of patient safety alerts received from the NHS central alert system and from the Medicines & Healthcare Regulatory Agency (MHRA).
• Ensure all patients on high risk medicines are monitored in accordance with national guidance and receive blood tests at appropriate intervals.
• Draw up a comprehensive business continuity plan.
• Develop a strategy and business plan to deliver the practice vision.
• Implement a program of quality improvement to include clinical audit to drive improvement in patient outcomes.

In addition the provider should:

• Improve Quality and Outcomes Framework performance particularly for diabetes indicators, to bring in line with local and national averages, and reduce exception reporting where it is above average.
• Consider ways to improve bowel cancer screening and cervical screening uptake.
• Identify and support patients who are also carers.
• Consider GP provision for gender specific requests.
• Develop the patient participation group.
• Introduce practice meetings and ensure they are minuted with action points.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice