Crown House Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crown House Surgery on 13 July 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.
• Risks to patients were assessed and well managed although some improvements were required in relation to systems for security of blank prescriptions.
• 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 did not always find it easy to make an appointment with a named GP. However, the practice had completed an extensive review into the appointment system and implemented changes. Urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

• There was a focus on continuous learning and improvement at all levels within the practice and the practice management team was effective and forward thinking to improve outcomes for their patients. The practice had developed a software system to assist them to effectively and safely manage and develop the practice. The system enabled all staff in the practice to monitor and review projects at any stage and to assign tasks and link related records such as meeting minutes. The system enabled the practice to provide good quality evidence of the project management and auditing systems in place.
• The practice demonstrated the effectiveness of the managements commitment to learning and improvement through extensive reviews of processes to identify areas for improvement. They also demonstrated, through the development and use of detailed care templates and protocols, improvement and delivery of best practice. Some of the areas they had improved included, safeguarding processes, access arrangements, continuity of care, effective use of GP appointments and care for patients with long term conditions.

The areas where the provider should make improvement are:

• Review the arrangements to monitor the patient safety alerts received and the actions taken in response to these.

• Review the arrangements for checks of the immunisation status of all staff.

• Review the storage and monitoring arrangements for blank prescription forms and pads in line with national guidance.

• Review and update the recruitment policy and procedure in relation to the checks required prior to employment.

• Review the arrangements for analysis of complaints to identify trends over a period of time. Review the details provided when recording the actions taken in response to complaints.

• Review the practice CQC registration partnership details and complete the processes to update these as necessary.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice