Archived: Richmond Road Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Richmond Road Surgery on 6 December 2016. The overall rating for the practice was good with requires improvement for being well-led. The full comprehensive report from December 2016 inspection can be found by selecting the ‘all reports’ link for Richmond Road Surgery on our website at www.cqc.org.uk.

This inspection was a desk based review carried out on 18 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 6 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• The provider submitted to the Commission further evidence as part of this inspection to support improvements undertaken to the governance framework and the delivery of good quality care. For example, drafting and implementation of a note summarising and data entry protocol and a test results protocol.
• The provider had commenced some clinical audits and reviews of patients outcomes to contribute to a programme of continuous quality assurance. We saw, from minutes of clinical practice meetings in May, June and August 2017, audits were discussed with staff.
• The provider had drafted and implemented an exception reporting protocol to ensure those patients who did not attend for a review, or where a medication cannot be prescribed due to a contraindication or side-effect were consistently managed.
• The practice had recently gathered feedback from patients through the patient participation group (PPG) and through a survey to consult with patients about moving all of the services to one site.
• Patient satisfaction with GP consultations had improved in the most recent (July 2017) National GP patient survey.

However, there is one area of practice where the provider should make improvement:

• The provider should review the clinical audit templates, used to capture all of the evidence, and include reference to the relevant National Institute for Health and Care Excellence (NICE) best practice guidelines as appropriate.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Richmond Road Surgery on 6 December 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. However the practice did not have the processes written down within a significant event policy. They have since written a policy and shared it with the commission.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 sometimes found it difficult to get through to the practice by telephone, however there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was equipped to treat patients and meet their needs.
• 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, however this was not contained within a written procedure.

The areas where the provider must make improvement are:

• Ensure a consistent approach to reviewing patient outcomes which contributes to a programme of continuous quality assurance.
• Ensure patient satisfaction with the service is monitored and action plans followed up and findings implemented.
• Ensure staff have access to relevant upto date policies and procedures to support them in their role.

The areas where the provider should make improvement are:

• Review how staff record actions taken as a result of current evidence based guidance and standards,including National Institute for Health and Care Excellence (NICE) best practice guidelines.
• Continue with the review of telephone access to the practice and establish a solution to improve access for patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice