Archived: Dr Elaine Tickle

Updated 27 April 2018

Dr Elaine Tickle is an individual provider offering primary care appointments with onward referral to diagnostic and specialist services as appropriate. The practice treats both adults and children. Dr Tickle is a qualified GP. The practice is introducing nurse appointments from March 2018.

The practice is open from Monday to Friday with consultations normally available from 9am until 4pm or 5pm from Monday to Thursday and until 2pm on Friday. There is some flexibility about appointment times and later appointments can be arranged. Patients are also given mobile contact details for the principal GP and information about a 24 hour visiting doctor service in London which they can use if they wish to consult an independent doctor out of hours.

The practice has a registered patient list with around 1600 patients, around 200 of whom frequently use the service. The principal GP told us they spend most of their clinical time with families, older people with longer term conditions and occasionally providing sexual health services and travel vaccinations. The practice also carries out health screening for employees of corporate clients; medico-legal case work and some occupational health services which fall outside the scope of this inspection.

The practice is located in a converted older property. The practice consultation rooms and office areas occupy the lower ground floor which is accessible by stairs. There is a shared waiting area on the ground floor. The landlord provides a range of property services, for example cleaning and maintenance.

We carried out this inspection of Dr Elaine Tickle’s practice on 15 February 2018. The inspection team comprised two CQC inspectors and a GP specialist advisor. Before visiting, we reviewed a range of information we hold about the service and asked the practice to send us some information about the service which we also reviewed.

During our visit we:

• Spoke with the staff who were present, including the principal GP, the practice manager and a medical administrator.
• Reviewed documentary evidence relating to the service and inspected the facilities, equipment and security arrangements.
• We reviewed a number of patient records alongside the principal GP. We needed to do this to understand how the service assessed and documented patients’ needs, consent and any treatment required.
• Spoke with five patients by telephone.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions formed the framework for the areas we looked at during the inspection.

Updated 27 April 2018

We carried out an announced comprehensive inspection on 15 February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Dr Elaine Tickle offers primary care appointments with a GP with onward referral to diagnostic and specialist services as appropriate. The practice treats both adults and children.

The principal GP is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• Systems were in place to protect people from avoidable harm and abuse.
• When mistakes occurred lessons were learned and action was taken to minimise the potential for reoccurrence. Staff understood their responsibilities under the duty of candour.
• Staff were aware of current evidence based guidance.
• Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
• Patient feedback indicated that patients were very satisfied with the service.
• Information about services and how to complain was available.
• There was clear leadership and staff felt supported. The practice team worked well together.
• There was a clear vision to provide a high quality, personalised service.
• The practice had systems in place to monitor and improve the quality of service provision.

We identified one regulation that was not being met and the provider must:

• Ensure care and treatment is provided in a safe way to patients.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review the security of any portable laptops used to access clinical record systems remotely to ensure that patient confidentiality is appropriately protected.
• Review its procedures to check the identity of children and accompanying adults attending the practice.
• Review its quality improvement programme and, for example, embed clinical audit more systematically in its monitoring of performance.