Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Winston Solomon on 20 December 2016. The overall rating for the practice was ‘requires improvement’. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Dr Winston Solomon on our website at www.cqc.org.uk.
This inspection was undertaken to follow up on the concerns identified in December 2016 and was an announced comprehensive inspection on 16 October 2017. Overall the practice is now rated as ‘good’.
Our key findings were as follows:
- There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
- The practice had clearly defined and embedded systems to minimise risks to patient safety.
- Staff were aware of current evidence-based guidance. Staff had been trained to implement the guidance; they had the skills and knowledge to deliver effective care and treatment.
- Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and their GPs involved them in their care and decisions about their treatment.
- Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients we spoke with said they could 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 the management team. The practice proactively sought feedback from staff and patients, which it acted on.
- The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
- The provider had acted to improve the quality of the service by responding to the concerns raised by CQC at the previous inspection in December 2016. For example, the provider had taken action to ensure the safe management of medicines and implemented a new, diabetes clinic to improve the quality of care for some patients.
We saw one area of outstanding practice:
The practice had made a commitment to improve outcomes for patients with diabetes. There was a weekly, diabetes-care clinic led by a GP with a special interest in diabetes; new patient education materials had been developed, and additional staff training had been arranged. This had successfully improved outcomes for all of the diabetic patients who had attended the clinic. This was demonstrated through a 2-cycle audit showing that patients attending the clinic had improved blood sugar readings; HbA1c levels showed an average reduction of 23 mmol/mol with the largest, single reduction in any patient being 49 mmol/mol.
The areas where the provider should make improvements are:
Review arrangements for minimising risks relating to the management of the premises.
Monitor patient feedback from all sources, including results from the national GP patient survey, to drive improvements in patients’ experiences of engaging with the provider.
Check that recent changes lead to increases in the number of carers identified and supported by the practice
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice