- GP practice
Archived: Willow House Surgery
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All Inspections
3 February 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Willow House Surgery on 3 February 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.
- 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 one area of outstanding practice:
The practice provides primary care to all the residents of a 76 bedded nursing home which specialises in supporting people with very complex health needs (multiple co-morbidities which is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases). These needs include advanced dementia and end of life care. In supporting these patients, the practice has developed a model alongside the staff of the nursing home and the London borough of Enfield Care Homes Assessment Team (CHAT), a team which supports GP’s and care homes that have complex residents. This model promotes integrated working across primary care, community care and secondary (specialist hospital care) and social care. Outcomes have included improved care planning with specialist service input and a reduction in hospital admissions including to A&E. The model was shortlisted for patient safety award in 2015 and this model is being adopted across London borough of Enfield’s nursing homes and being considered for implementation by neighbouring local authorities.
The areas where the provider should make improvement are:
- Improve systems to identify and support carers in line with published guidelines.
- Include information on how to make a complaint on the practice’s website.
- Develop a clear terms of reference for the patient participation group (PPG) which focuses on improving health and wellbeing outcomes for its patient population.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
28 May 2014
During a routine inspection
Willow House Surgery is located in the London Borough of Enfield. The practice provides primary medical services to around 3,500 patients .
We carried out an announced inspection on 28 May 2014. The inspection took place over one day and was led by a lead inspector and a GP. An expert by experience was also part of the inspection team.
During our inspection we spoke with 12 people who used the practice, and we received and reviewed six comments cards. We spoke with six members of staff.
The regulated activities we inspected were diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease and disorder or injury.
We saw that the service was responsive to the needs of older people, people with long term conditions, mothers, babies, children and young people, the working age populations and those recently retired, people in vulnerable circumstances and people experiencing poor mental health. People with long term conditions such as diabetes or coronary heart disease received regular health reviews at the practice.
Willow House Surgery provided a caring, effective and responsive service. Patients’ needs were suitably assessed and treatment was delivered in line with current legislation and best practice. GP’s received an alert on their computer system when health checks were due. We saw the recall system which alerted GPs when children’s immunisations were due. The practice arranged for people with long term conditions to attend for regular health care reviews on at least a six monthly basis. There was good access to appointments. We saw they responded to appointment requests for young children and babies and classified them as urgent. Home visits were undertaken according to people’s needs.
Medicines for dealing with medical emergencies were held at the practice and staff had received training in Cardiopulmonary resuscitation (CPR). There were safe systems for the management of medicines, specifically controlled drugs which had been monitored and recorded in line with requirements.
The practice was clean and completed regular infection control audits. Staff had received annual training in infection control.
The practice had safeguarding policies and procedures in place. All staff had received training in safeguarding children and vulnerable adults.
There were formal processes in place for the recruitment of staff. A disclosure and barring service (DBS) check (formally known as a criminal record bureau (CRB) check) had been obtained for all clinical staff. Assessments had not been completed for those staff assessed as not in need of a check. This meant patients were not fully protected against the risks associated with the recruitment of staff.
The practice was well-led on a day-to-day basis and there was a vision in place in regards to the management and planning of the service.
We saw the practice had procedures in place to inform people of the services available. This information was available in languages other than English. Language Line, a telephone interpreting service was used regularly by the staff team.
The practice delivered high quality patient care through an ethos and culture that was caring and responsive. All staff were clear about their role and responsibilities and the values of the practice. Staff were given the support they needed to do their job.