You are here

Inspection Summary


Overall summary & rating

Good

Updated 23 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ash Trees Surgery on 14 October 2014. The overall rating for the practice was good, although the practice was rated as requires improvement for safety. The full comprehensive report on the October 2014 inspection can be found by selecting the ‘all reports’ link for Ash Trees Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 September 2017 to assess the improvements that the practice had made following the recommendations laid out at our previous inspection on 14 October 2014. This report covers our findings in relation to those improvements made since our last inspection.

The practice is now rated as good for safe services, and overall the practice is rated as good.

Our key findings were as follows:

  • The practice had taken action to address the concerns raised at the CQC inspection in October 2014. Risk assessments and policies had been in place for some time to improve safety in areas such as patient consent, infection control and medicines management.
  • There was a central record of staff training, and we saw that staff were undertaking the training required for their role.
  • There was a register of patients who were carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 23 October 2017

The practice is rated as good for providing safe services. The practice had taken action to address the concerns raised during our previous inspection in October 2014. They had:

  • Put risk assessments and policies in place to improve safety regarding infection control and medicines management;
  • Carried out infection control audits, and ensured that clinical waste was stored appropriately;
  • Ensured that Patient Specific Directions were appropriately signed before patients presented for treatment;
  • Provided training for staff in the Mental Capacity Act 2005;
  • Put in place a central record of staff training;
  • Created a record of patients with carer responsibilities;
  • Ensured clinicians had electronic access to patients’ warfarin test results;
  • Made sure all single use clinical equipment was appropriately stored and not opened before use.

Effective

Good

Updated 8 January 2015

The practice is rated good for effective. Data showed the patient outcomes were at or above average for the locality. People’s needs were assessed and care was planned and delivered in line with current legislation. This included promotion of good health. Staff had received training appropriate to their roles and further training needs had been identified and planned. The practice had systems in place for appraisal and personal development of staff. Multidisciplinary working was evidenced.

Caring

Good

Updated 8 January 2015

The practice is rated as good for caring. Data showed the practice rated higher than others for certain aspects of care. For example, the percentage of patients who had comprehensive care plans documented and agreed with individuals, family and/or carers as appropriate. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them. The practice had outstanding arrangements in place to offer patients/carers support to cope emotionally with care and treatment, for example, The Listening Service. We saw that staff treated patients with kindness and respect, ensuring confidentiality was maintained.

Responsive

Good

Updated 8 January 2015

The practice is rated as good for responsive. The practice reviewed the needs of their local population and engaged effectively with the NHS Local Area Team and Clinical Commissioning Group (CCG) to secure service improvements where these were identified. Patients reported good access to appointments. GPs maintained personal lists offering patients continuity of care. Urgent same day appointments were available as required. The practice had good facilities and was well equipped to treat patients and meet their needs. There was an accessible complaints system with evidence demonstrating the practice responded quickly to issues raised. There was evidence that learning from complaints was shared with staff.

Well-led

Good

Updated 8 January 2015

The practice is rated as good for well-led. The practice had a clear vision which had quality and safety as its top priority. The strategy to delivery this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles. The practice planned for succession. We found there was a high level of constructive staff engagement and a high level of staff satisfaction. The practice sought feedback from patients which included use of technology. The practice had a patient participation group and future plans included further development of this.

Checks on specific services

Older people

Good

Updated 8 January 2015

The practice is rated as good for the care of older people. The practice had a significantly greater proportion of older people within its patient population than the national average. They offered proactive personalised care to meet the needs of patients and had a range of enhanced services, for example end of life care. The practice was responsive to the needs of older people, including offering home visits to patients living independently. The number of patients within the practice population living in nursing/residential homes also exceeded the national average. GPs carried out scheduled home visits to these patients.

People with long term conditions

Good

Updated 8 January 2015

The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. Longer appointments and home visits were available if required. GPs maintained personal lists so each patient had a named GP. Systems were in place to carry out structured annual reviews to check patients’ health and medication needs were being met. Where patients had complex health needs GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 8 January 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place to highlight vulnerable patients on the electronic records. The practice held quarterly multi-disciplinary meetings with health visitors in relation to safeguarding issues, including consideration of looked after children. Immunisation rates were relatively high for standard childhood vaccinations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Working age people (including those recently retired and students)

Good

Updated 8 January 2015

The practice is rated as good for the population group of working age people (including those recently retired and students). Patients were able book appointments and request repeat prescriptions using on line services and the practice offered appointments with GPs and nurses during extended hours. A range of health promotion and screening services were available which reflected the needs for this age group.

People whose circumstances may make them vulnerable

Good

Updated 8 January 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. A register was maintained of those patients with learning disabilities. Care plans were developed to support patients and the practice carried out annual health checks. Extended appointments were arranged and the practice worked in conjunction with the local authority learning disability team to follow up on any non-attendance. The practice offered a minor injury service for both registered and non-registered patients. Systems were in place to notify a patient’s usual GP in a timely manner if a non-registered patient had required treatment.

People experiencing poor mental health (including people with dementia)

Good

Updated 8 January 2015

The practice is rated good for the population group of people experiencing poor mental health (including people with dementia). Registers of people experiencing poor mental health were maintained and patients had annual health checks. The practice was a pilot site for easy access to mental health which promoted self-referral to counselling.