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The Surgery - Sloane Street Requires improvement

Reports


Inspection carried out on 24 April 2019

During a routine inspection

This service is rated as Requires improvement

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out a comprehensive inspection at The Surgery – Sloane Street as part of our inspection programme.

The service provides a private GP service to adults and children.

The provider is registered with the Care Quality Commission for the regulated activity of Treatment of Disease, Disorder or Injury.

The lead GP partner 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.

Forty-five people completed CQC comment cards prior to the inspection. All the feedback was very positive about the service. People said that they always received a quality service and they expressed high praise for all the staff.

Our key findings were:

  • The prescribing of high risk medicines was not carried out safely. A past serious incident involving a patient who was prescribed a high risk medicine without appropriate monitoring had not been learned from.
  • The provider had systems in place to keep clinicians up to date with current evidence based practice.
  • There was evidence of quality improvement activity including clinical audit.
  • Feedback from patients was very positive. Patients reported that staff were kind and caring and provided an excellent service.
  • Patients reported timely access to the service. They said that they could get an appointment time that suited them.
  • Complaints were taken seriously and used to improve the service.
  • The systems for monitoring safety were not always effective.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review safeguarding training requirements for non-clinical staff to ensure that it is in line with intercollegiate guidance.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 8 February 2018

During a routine inspection

We carried out an announced comprehensive inspection on 8 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 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.

The Surgery – Sloane Street provides private general medical services to adults and children.

One of the GP partners 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.

The provider is registered with the Care Quality Commission for the regulated activities of treatment of disease, disorder or injury.

Eighty three people provided feedback about the service which was all very positive. People expressed a high satisfaction with the service provided with particular praise for the staff. They said that they received a very high standard of care from all staff at the practice.

Our key findings were:

  • The practice had clear systems to keep patients safe and safeguarded from abuse.
  • There were systems to assess, monitor and manage risks to patient safety.
  • The practice had reliable systems for appropriate and safe handling of medicines.
  • The practice learnt and made improvements when things went wrong.
  • The provider assessed needs and delivered care in line with relevant and current evidence based guidance and standards.
  • Staff had the skills, knowledge and experience to carry out their roles.
  • Staff treated patients with kindness, respect and compassion.
  • Patient feedback showed a high satisfaction with the service provided with particular praise for the staff.
  • Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
  • The practice had effective leadership and governance arrangements.

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

  • Review the medicines management arrangements in respect of unlicensed medicines.
  • Review how prescription pads used for home visits are monitored.
  • Review procedures to ensure that the adult attending with a child has parental responsibility to consent to care and treatment.
  • Review the strategy to deliver the vision of the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 18 June 2013

During a routine inspection

People told us they were very happy with all aspects of the service and had recommended it to others. They told us they were able to arrange an appointment with the doctor of their choice and they could contact them in an emergency. People we spoke with said "I just ring when I need to see someone" and "they're happy to talk to me when I'm worried about something".

People told us they were provided with sufficient information and had opportunities to discuss their health care needs in detail.

We found people’s needs were assessed and care and treatment was planned and delivered in line with their individual wishes. Consultations were held in private and the findings were recorded at the time in people's medical records.

There were arrangements in place to deal with foreseeable emergencies and all staff were trained to deal with medical emergencies and in basic life support.

People told us they "trusted everyone working in the practice. They're amazing". Staff were supported in their roles through robust induction, appraisal and training policies. The provider had an effective system to regularly assess and monitor the quality of service that people receive.

Inspection carried out on 10 June 2011

During a routine inspection

In the case of this location it was impracticable to undertake a visit when patients were on site, so we did not speak to people who use services.

Reports under our old system of regulation (including those from before CQC was created)