22 March 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr M Hargreaves and Dr P Thakrar on 22nd March 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.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
- Patients said they found it easy to make an appointment with a named GP and that 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, apart from the availability of a defibrillator and a risk assessment for this.
- There was a clear leadership structure and staff felt supported by management. The practice 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.
- Some staff were trained in child safeguarding to a higher level than required, including nurses to level 3. The practice manager had attended training at level 5 (managing staff who safeguard children).
We found areas of outstanding practice:
- Feedback from patients who use the service was continually positive with a strong visible patient centred culture.
- The practice delivered additional support for socially isolated older patients, for example, the practice telephoned socially isolated patients on Christmas day to provide support.
- The practice had implemented a local policy to ensure that patients received phone call support following bereavement at one, three, six and 12 months afterwards.
The areas where the provider must make improvement are:
- Review the arrangements for emergency care at the practice and consider purchasing a defibrillator or complete a risk assessment.
The areas where the provider should make improvement are:
- Ensure the staff at the practice undertake regular fire drills.
- Ensure prescriptions are tracked and managed safely in the practice, including when held in GPs own bags.
- Review the systems for tracking samples sent from the practice for testing to ensure that results are tracked and reported in a timely manner.
- Review the systems in place for clinical coding to make sure it accurately reflects care given to patients with specific medical condition and national guidelines.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice