18 May 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Kensington Partnership, Lower Grange Medical Centre on 18 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 in place for reporting and recording significant events.
- Risks to patients were assessed and well managed and supported by the computer systems used by the practice.
- 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 find easy to make an appointment with a named GP. Urgent appointments were available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- Reception staff were infrequently acting as chaperones without a Disclosure and Barring Service check (DBS). (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). As these staff were not DBS checked and there was no risk assessment in place for this, we were assured that this would stop from the day of our visit.
- There was a clear leadership structure and staff felt supported by management. The practice worked closely with the Patient Participation Group (PPG) and proactively 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 practice had completed five out of six modules to gain accreditation and attain the Gold Standards Framework. The Gold Standards Framework is a systematic, evidence based approach to optimising care for all patients approaching the end of life.
- A Polish and a Czech interpreter were available at the Kensington Street Health Centre site each day to assist patients, who also had access to a benefits adviser one morning per week.
We saw areas of outstanding practice:
The practice offered a level two diabetes clinics where patients could be commenced on insulin therapy without attending hospital. (Insulin is a drug used for diabetics which keeps blood sugar levels from getting too high or too low). This clinic was offered to patients from other surgeries.
We saw excellent use of the clinical computer system used by GP practices in the area. The practice had developed a number of clear and proactive protocols, templates and care plans which helped staff to care for patients in a timely manner and to keep people well and safe. This included a reception protocol developed by GPs at the practice which allowed reception staff to ensure that patients received the most appropriate care and treatment. This clinically led, risk based protocol would direct staff to ring for an ambulance if required, book appointments urgently or ask people to speak to the pharmacy depending on their age and symptoms.
The practice engages the services of both a Polish and a Czech interpreter daily to assist patients with consultations and any issues. There was a benefits adviser available in the practice one morning a week.
The areas where the provider should make improvement are
The practice should ensure that all staff receive an annual appraisal.
The practice must ensure that all staff who act as chaperones for patients have undergone a Disclosure and Barring Service check (DBS).
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice