Letter from the Chief Inspector of General Practice
Townsend House practice was inspected on Tuesday 14 October 2014. This was a comprehensive inspection.
Townsend House provides primary medical services to people living in the town of Seaton and the surrounding areas. The practice provides services to a diverse population age group and is situated in a town centre location.
At the time of our inspection there were approximately 6200 patients registered at the service with a team of three GP partners. GP partners held managerial and financial responsibility for running the business. In addition there were three part time salaried GPs, three registered nurses, two healthcare assistants the practice manager, and additional administrative and reception staff.
Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.
Our key findings were as follows:
Patients reported having good access to appointments at the practice and liked having a named GP which improved their continuity of care. The practice was clean, well organised, had good facilities and was well equipped to treat patients.
The practice valued feedback from patients and act upon this. Feedback from patients about their care and treatment was consistently positive. We observed a non discriminatory, person centred culture. Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Views of external stakeholders were very positive and aligned with our findings.
The practice was well-led and had a clear leadership structure in place whilst retaining a sense mutual respect and team work. There were systems in place to monitor and improve quality and identify risk and systems to manage emergencies.
People’s needs were assessed and care is planned and delivered in line with current legislation. This includes assessment of capacity and the promotion of good health.
Documentation about the practice demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area. Patients told us they felt safe in the hands of the staff and felt confident in clinical decisions made.
Significant events, complaints and incidents were investigated and discussed. Learning from these events was performed and communicated, although the written evidence for this process did not always consistently show what learning and actions had been taken following such investigations.
We saw one area of outstanding practice:
Specific appointments were made which supported and treated patients with diabetes; they included education for patients to learn how to manage their diabetes through the use of insulin. Health education about healthy diet and life style for patients with diabetes was provided. The practice also held a virtual diabetic clinic with two other GP practices and a hospital diabetic consultant. This is a time where patients with complex needs could be discussed confidentially with the specialist, and GPs received education on the management of patients with complex cases. There were also areas of practice where the provider needs to make improvements.
The provider must:
All staff required to chaperone patients must have a DBS check in place. In addition to this a record should be kept to explain the decisions that have been informally made in relation to staff not having a criminal record check using the disclosure and barring service (DBS).
In addition the provider should:
An updated fire risk assessment should be undertaken.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice