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Inspection carried out on 6 January 2017
During a routine inspection
Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Palacci & Partners on 6 January 2017. 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 a system in place for reporting and recording significant events.

  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • 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 majority of patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had the facilities and equipment 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

  • Review the process for producing patient specific directions (PSDs) for the annual flu vaccination programme to ensure the administration of medicines remains safe up to the point of them being administered.
  • In carrying out daily temperature checks of vaccine storage fridges, record the name of the member of staff who completes the checks. Arrange for the protocol containing instructions on action to take if fridge temperatures exceeded the required range to be kept by the fridges.
  • Review the coding of dementia patients to determine clearly the basis for any clinical exceptions.
    Consider the introduction of a formal ongoing programme of quality improvement, including clinical audit.
  • Arrange support training on communicating with patients about notifiable safety incidents
    to ensure staff take appropriate action.
  • Re-establish the patient participation group (PPG) on a more active footing and encourage wider patient membership.

Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice