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Forest Hill Group Practice Good

We are carrying out a review of quality at Forest Hill Group Practice. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Good

Updated 29 March 2018

This practice is rated as Good overall. At our previous inspection on 22 June 2017 the practice was rated as inadequate and placed into special measures this followed our first inspection on 12 April 2016 where the practice was rated as requires improvement.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Forest Hill Group Practice on 8 February 2018. This inspection was undertaken as the service was rated as inadequate at our previous inspection and placed into special measures. At our last inspection on 22 June 2017 the practice was rated as inadequate for providing services that are safe and well led and requires improvement for effective. We identified breaches of regulations 12 and 17 of the Health and

Social Care Act 2008 (Regulated Activities) Regulations 2014. Breaches related to the practice failing to adequately assess and mitigate risks associated with infection control, the management of medicines and equipment, and recruitment and monitoring. In addition, the practice’s chaperoning procedures did not ensure patients were kept safe. The practice had also not reviewed high rates of exception reporting and did not have adequate systems in place to follow up patients following a cervical screening test.

Prior to that we inspected the service on 12 April 2016 and rated the service requires improvement for providing care that was safe, effective and well led. We identified breaches of regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Breaches related to deficiencies in safety systems for the management of medicines, infection control, recruitment and training. There was also limited evidence of quality improvement work, lack of effective systems relating to the management of significant events and a lack of effective policies and processes. Staff also had not received an annual appraisal and there was a lack of mechanisms to ensure staff felt supported.

At this inspection we found:

That the concerns from our previous inspection had all been addressed. The practice had taken action not only to address the concerns identified on our last inspection but also to improve leadership and management to ensure that improvements made were embedded and sustained.

For example:

  • The practice now had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

  • Staff treated patients with compassion, kindness, dignity and respect.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

However:

  • Although national patient survey scores were largely positive in respect of access, some patients that we spoke with on the day of the inspection found it difficult to access routine appointments or get through on the telephone and the next available routine GP appointment was four weeks. The practice had recently recruited four additional salaried GPs with a view to improving both access and continuity of care for patients and was in the process of upgrading their phone systems.

  • The practice had not met Public Health England targets related to childhood immunisations and cervical screening. Public Health England data for targets related to smoking cessation also indicated that the practice was performing below local and national averages though unverified data provided by the practice indicated that they were meeting this target.

The areas where the provider should make improvements are:

  • Work to monitor and improve access to routine appointments and to monitor and improve telephone access.

  • Work to improve the care of patients with rheumatoid arthritis and fragility fractures, increase the uptake of childhood immunisations and review higher than average exception reporting rates.

  • Improve systems and processes that support the identification and record keeping in respect of patients with caring responsibilities to enable appropriate support and signposting to be provided.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 29 March 2018

Effective

Requires improvement

Updated 29 March 2018

Caring

Good

Updated 29 March 2018

Responsive

Good

Updated 29 March 2018

Well-led

Good

Updated 29 March 2018

Checks on specific services

People with long term conditions

Good

Updated 29 March 2018

Families, children and young people

Good

Updated 29 March 2018

Older people

Good

Updated 29 March 2018

Working age people (including those recently retired and students)

Good

Updated 29 March 2018

People experiencing poor mental health (including people with dementia)

Good

Updated 29 March 2018

People whose circumstances may make them vulnerable

Good

Updated 29 March 2018