The New Surgery

Letter from the Chief Inspector of General Practice

In May 2016, during an announced comprehensive inspection of Drs Robertson-Ritchie, de Caestecker, Mukherjee, Mah and Meera Patel, we found issues relating to the practice’s recruitment process for new employees.

During this inspection in May the practice had informed us, that they did not routinely collect employment and character references for new members of staff, including clinical members of staff for example GPs and Nurses. This was assessed as being in breach of the Health and Social Care Act 2008 Regulations. As a result the practice was rated as requiring improvement for safe services. It was rated as good for effective, caring, responsive and well led services, and awarded an overall rating of good.

Following the inspection the provider sent us an action plan detailing how they had reviewed and were now following their updated recruitment policy, ensuring that employee and character references were sought for all new members of staff. The practice also provided retrospective employee and character references for staff employed within the last three years.

We carried out a focused inspection of the practice in September 2016 to ensure these changes had been implemented and that the service was meeting regulations.

We found the practice had made improvements since our last inspection in May 2016, and that it was meeting the regulation relating to assessing that all staff employed were of good character, which had previously been breached.

Following this focused inspection we have rated the practice as good for providing safe services. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report of 10 May 2016. A full copy of the report can be found on the CQC website at: www.cqc.org.uk.

At this inspection we found:

• The practice had sourced retrospective references for staff employed within the last three years.

• The practice had ensured that systems were in place in order that all staff recruited were of good character.

• The practice had reviewed its updated policy and procedures relating to staff and recruitment checks, and was now following this.

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 Drs Robertson-Ritchie, de Caestecker, Mukherjee, Mah and Meera Patel on 10 May 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 for reporting and recording significant events.
• Most risks to patients were assessed and well managed. However, the practice did not routinely collect employment or character references for new members of staff.
• 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. However, the practice had not replied to comments on the NHS Choices website.
• Patients said that they were able to get appointments, but that getting through to the practice on the telephone could be difficult. 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. However, the entrance door to the premises did not have an automatic opening system to allow access for patients who were wheelchair users. The reception desk did not have a lower area to allow this patient group to communicate with the reception staff.
• There was a clear leadership structure and staff felt supported by management. The practice 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.

The areas where the provider must make improvement are:

• Ensure the recruitment process is robust and includes collecting employment and character references.

The areas where the provider should make improvement are:

• Review how patients who use wheelchairs access the premises and communicate with members of staff at the reception desk.
• Review and reply to complaints on the NHS Choices website.

• Review the care of patients diagnosed with dementia, including face to face reviews, to ensure all care needs for this group of patients were being met.
• Revise the system that identifies patients who are also carers to help ensure that these patients are offered relevant support.
• Review clinical audit activity to ensure improvements to patient care are driven by the completion of clinical audit cycles.
• Review the process for appraisals for the nursing team.
• Review how patients access appointments by telephone.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice