Archived: Dr RM Rowland's Practice Also known as The Jenner Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr RM Rowland’s Practice on 16June 2015.

We found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working age people including those recently retired and students, people whose circumstances make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• There were comprehensive systems in place to ensure that the practice provided safe care. The practice reviewed policies regularly to ensure that they remained fit for purpose. The practice also had an appropriate system in place to review untoward incidents which were used to inform how services might be developed to improve patient care.

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents.

• The practice did not own the building from which it operated. Those areas of care provision (such as some aspects of infection control) which required working with the owner of the building were less effective. The practice had written to the owner of the building in order to address this. The practice had specifically asked for cleaning orders, improved toilet facilities on site and further cleaning to these facilities.

• Outcomes for patients at the practice were in line with or better than national averages, and a developed system of audit was in place at the practice, with evidence that this had led to improvements in patient care.

• Multidisciplinary meetings were carried out and information was shared with a range of different services to ensure continuity of care for patients.

• Patients reported that they were pleased with the level of service provided by the practice, and an active patient participation group was in place at the practice, with whom the practice had worked to improve services to patients.

• The practice had actively reviewed its patient population so that services could be targeted to meet the needs of everyone.

• Information about services and how to complain was available and easy to understand. This included the practice’s website which was thorough, clear and informative. Appointments could be made and prescriptions requested online.

• There was a clear practice strategy, which included delivering improved governance over the next two years.

• Staff felt well-supported by the practice team and felt able to raise any concerns

We saw several areas of outstanding practice including:

• Care plans were in place for many patients in the practice. For example the practice had recently allocated each of its housebound patients over the age of 75 to one of the duty doctors, and when they had been the “on call” doctor at the practice they had proactively contacted and visited each of these patients over a two month period. New care plans had been implemented for those patients that needed them. A further example was that the practice worked closely with a homeless hostel in the area, and had again proactively seen patients to determine whether or not a formalised care plan would be of benefit.

• Two staff at the practice had taken a course in basic sign language such that a better service could be provided to patients with hearing difficulties. This was appropriate given the needs of the practice population.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

• Ensure with the owner of the practice that they are provided with infection control information including environmental audits, and that the patient toilets in the practice are appropriately cleaned and fit for purpose. Further ensure that any areas not cleaned by the building’s owner (for example computer equipment) are kept clean.

• Ensure that all checks that have been completed and safety measures taken are clearly recorded (this includes checks on emergency equipment, records of drug expiry dates and staff immunisations against hepatitis).
• Ensure that where vaccine refrigeration temperatures are outside of safe ranges that any actions are recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice