Archived: The Enterprise Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Enterprise Practice on 10 October 2017. Overall the practice is rated as requires improvement.

The Enterprise Practice was previously inspected in February 2015. Overall the practice was rated as good, however the practice was rated as requires improvement for providing safe services. The full comprehensive report on the February 2015 inspection can be found by selecting the ‘all reports’ link for The Enterprise Practice on our website at www.cqc.org.uk.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, lessons learned were not always communicated widely enough to support improvement.
• There were inconsistent arrangements in how risks were assessed and managed.
• The practice was unable to demonstrate that all appropriate recruitment checks had been undertaken prior to employment.
• The practice had a number of policies and procedures to govern activity and most were updated and reviewed regularly.
• Data showed patient outcomes were lower than average for childhood immunisation rates and the cervical, breast and bowel cancer national screening programme uptakes.
• Most staff had received up to date training relevant to their role. Staff appraisals had been completed in a timely manner.
• We found one completed clinical audit cycle which was driving positive outcomes for patients.
• Feedback from patients reported that access to pre-bookable GP appointments was limited.
• Patients we spoke with on the day informed us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice was renting a space in a shared premises but the practice was unable to demonstrate that they had an effective monitoring system to ensure that regular health and safety checks had been undertaken and action plans had been followed up by the contractor who was responsible for managing the premises.
• There was a clear leadership structure and staff felt supported by management. However, the practice was unable to demonstrate that the nursing staff had attended the team meeting or received the team meeting minutes.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

In addition the provider should:

• Review the system in place to promote the benefits of childhood immunisation, cervical, breast and bowel cancer national screening in order to increase patient uptake.
• Review patient feedback and address the concerns raised regarding the availability of pre-bookable appointments.
• Provide patient information in languages and formats suitable to the patient population.
• Share the learning and team meeting minutes widely if staff are unable to attend the team meetings.
• Review the appropriate staff training necessary to enable them to carry out their duties.
• Review that all appropriate emergency medicines are in stock and remind all staff about their location.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice