During an assessment under our new approach
Date of Assessment: 27/06/2025 to 3/07/2025. The assessment was due to the length of time since we last assessed the service. Pinner View Medical Centre is a GP practice and delivers service to 5690 patients under a contract held with NHS England. The National General Practice Profiles states that the ethnicity of the practice population is 44.04% Asian, 36.82% White, 5.23% Mixed, 6.88% Black and 7.03% Other. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 8th decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. The facilities and equipment met the needs of people, were clean and well-maintained.
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Staff involved those important to people and took decisions in people’s best interests where they did not have capacity.
People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and treatment. The service supported staff wellbeing.
People were involved in decisions about their care. The service provided information in a manner people could easily understand. People knew how to give feedback and make complaints and were confident the service took it seriously and acted on it. The service was easy to access.
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally. Staff understood their roles and responsibilities. However, we found that the service did not always have clear systems of good governance.
During our on-site visit, we found that there were gaps in training and recruitment files for some staff. The service took action after our visit to put this right and we saw evidence that staff were now all up to date with their required training. During our on-site visit, we found that the practice did not have recent calibration carried out on equipment. The practice did not have a fire risk assessment and the health and safety risk assessment was overdue. Since the inspection, the practice has had calibration, a fire risk assessment and a health and safety assessment all carried out.
We found breaches of regulation in relation to Regulation 17 – Good governance. We have asked the provider for an action plan in response to the concerns found at this assessment.