Letter from the Chief Inspector of General Practice
The Vineyard Surgery provides general medical services to approximately 3700 patients in Richmond, Surrey. It is one of two practices operated by this provider.
We visited the practice on 27 October 2014 and carried out a comprehensive inspection of the services provided.
We rated the practice as ‘Requires Improvement’ overall; ‘Good’ in the domains of caring and responsive and ‘Requires Improvement’ in the domains of safe, effective and well led. We rated the practice as ‘Requires Improvement' for all six population groups we looked at including older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances and people experiencing poor mental health (including people with dementia).
Our key findings were as follows:
The practice provided a caring and responsive service. There was a good skill mix amongst staff at the practice. Patients’ needs were suitably assessed and care and treatment was delivered in line with current legislation and best practice. We saw from our own observations and heard from patients they were treated with dignity and respect. The practice understood the needs of its patients and was responsive to them.
Our key findings were as follows:
- Staff at the practice were aware of the need to report incidents, complaints and safeguarding concerns
- The number of incidents was low but where they had occurred investigations, outcomes and actions were clearly documented
- All patients we spoke with during the inspection told us they felt safe in the care of the doctor and nurses at the practice
- The practice was clean and there was a nominated infection control lead
- The practice scored above the CCG average for the ease of making an appointment
- Patients we spoke with on the day and who left comment cards felt they were consulted and involved in their care, and were treated with dignity and respect
- Staff were complimentary about the availability to training; and the visibility and access to the partners
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Put a system in place to disseminate learning from incidents, complaints, safety alerts and significant events to all staff and use such occurrences for risk assessment and quality improvement
- Ensure that recruitment processes are thorough, and include seeking references, proof of identity and, where appropriate, a criminal records check for new staff
- Complete the infection control audit and take action where appropriate
- Review the procedure for actioning test results to ensure they are promptly dealt with
- Provide staff with regular supervision and annual appraisal
- Ensure there is a governance framework to support the delivery of good care
In addition the provider should:
- Advertise to patients that they can request a chaperone if they wish for one
- Keep a log of prescription pad numbers
- Monitor the cleaning contract
- Update the business continuity plan
- Provide all new staff with an induction
- Provide regular team meetings and facilitate all staff attendance where possible
- Have a consistent vision for the practice and a strategy to deliver this
- Monitor medicines to ensure that they remain in date
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice