7 July 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Open Door (Health) Limited on 7 July 2016. 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 managed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
- The majority of patients said they were treated with compassion, dignity and respect. However, some patients said they did not feel supported, listened to and involved in decisions about their care.
- Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
- 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 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.
We saw two areas of outstanding practice:
- The Herbert protocol is a national scheme for patients with dementia. It records vital information about the person in advance. Information such as medication, description, photograph, significant places in the person’s life and their daily routine. This can then be used in event of a vulnerable person going missing. The information will help the police and other agencies locate the missing person as quickly as possible and return them to safety. The practice apply the Herbert protocol to all their patients with dementia.
- Nursing staff used a memory box to occupy patients with dementia whilst their carer receives treatment. (The memory box contained items from the patients’ earlier life and times and helped reassure and calm them).
The areas where the provider must make improvement are:
- Ensure there is an appropriately qualified and clinically skilled individual present when the practice is open to see patients on days when the GP is absent.
- Ensure recruitment arrangements include all necessary employment checks for all staff.
- Risk assesses the lack of provision of emergency oxygen.
The areas where the provider should make improvement are:
- Obtain appropriate emergency medicines and ensure safe systems are put in place for their safe storage and management.
- Put in place a system for the checking and maintenance of the defibrillator.
- Record actions following the receipt of national safety alerts.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice