Dr H Tattersfield & Mr M Lenzi Also known as Oakview Family Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 8 March 2016. Breaches of the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found and the practice was rated as Requires Improvement for Safety. After the comprehensive inspection, the practice wrote to us to say what they would do to address the breaches of regulation. We undertook this focussed inspection on 28 November 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where other improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr H Tattersfield & Mr M Lenzi on our website at www.cqc.org.uk. Overall the practice is rated as Good. Specifically, following the focussed inspection we found the practice to now be good for providing safe services.

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

• Risks to patients were assessed and well-managed, including those related infection prevention and control, fire and electrical safety and equipment for dealing with medical emergencies.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr H Tattersfield & Mr M Lenzi on 8 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.
• Although risks to patients who used services were assessed, the systems and processes to identify and address risks were not implemented well enough to ensure patients were kept safe. Fire risk assessments and infection control audits had failed to identify significant risks and some actions that had been identified had not been addressed.
• 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.
• 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.

We saw an area of outstanding practice:

• The practice identified and responded to the needs of its patients. In response to evidence of links between poor diet and poor child health, the partners set up a nutrition programme providing advice and skills training to local families. This became the Downham Nutrition Partnership, a registered charity and company limited by guarantee, which supports projects to improve the health and lifestyle of local people. The practice was one of the charities partners and the lead GP is the charity’s Chair. Some of the projects included: community allotments, a fruit and vegetable co-operative shop and cooking and healthy eating courses for children and families. The charity worked with local schools to provide fruit and set up breakfast clubs before these became national initiatives.

The areas where the provider must make improvements are:

• Improve infection control procedures, to ensure that the practice is clean and hygienic. Identify a lead staff member to liaise with local infection prevention teams to keep up to date with best practice and conduct regular checks and audits.
• Ensure that there is adequate fire exit signage and firefighting equipment.
• Ensure that the required checks of electrical safety and emergency equipment are carried out.

In addition the provider should:

• Ensure patients are aware of translation services that are available.
• Continue to review patient feedback about access to preferred GP and waiting times.
• Consider how to facilitate gender specific requests for a GP or chaperone.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice