The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Y E M Owen & Dr D I A Smith Also known as The Wolds Practice

Overall: Good read more about inspection ratings

West Road, Tetford, Horncastle, Lincolnshire, LN9 6QP (01507) 534903

Provided and run by:
Dr Y E M Owen & Dr D I A Smith

All Inspections

21 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Y E M Owen & Dr D I A Smith, The Wolds Practice on 21 January 2016. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice had been responsive to the identified needs of patients and employed a counsellor to assist people experiencing anxiety and a nurse practitioner to meet the needs of the over 75s.
  • The practice was proactive in identifying carers and supporting them as far as possible in both looking after the health and social needs of both themselves and the cared for patient.
  • Information about services and how to complain was readily available and easy to understand.
  • Patients said they found it easy to make an appointment 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.

We found areas of outstanding practice which included;

  • The practice had employed a nurse practitioner with the aim of reducing the number of emergency admissions and inappropriate attendance at accident and emergency for patients aged over 75. Their work had resulted in a reduction in emergency admissions for a sustained period of ten months and a sustained reduction in inappropriate attendance for nine months.This has been acknowledged by the CCG as a ‘ step change’. Avoiding inappropriate admissions and attendance at A&E is important because it ensures that patients receive timely care in an environment which is familiar and more convenient for them.

  • The practice employed a counsellor to provide talking therapies to bereaved patients and those experiencing mild to moderate anxiety. This had reduced the wait time to access help and support for this group of patients from in excess of six months to around a month.

However there was an area of practice where the provider should make improvements:

  • The provider should ensure that clinical meetings are properly recorded and non-attenders made aware of the content.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

15 January 2014

During an inspection looking at part of the service

We spoke with the chairperson of the patient participation group who was also a patient at the practice. They told us, 'I am more than happy with the cleanliness of the practice.' We saw that the surgery had been decorated since our last visit and all rooms were clean. We saw the treatment room was tidy with clear worktops, this enabled easy cleaning.

The service protected people against the risks associated with the unsafe use and management of medication by way of appropriate arrangements.

We saw the provider had contact the relevant professional body to ensure clinical staff were registered and up to date with training and skills.

Staff received appropriate induction training and appraisals.

A patient participation group was in place and had regular meetings to discuss how the practice could better meet patient's needs. Incidents were investigated properly and actions taken to reduce the risk of them re-occurring. Appropriate health and safety checks were in place.

23 October 2013

During an inspection in response to concerns

We conducted our inspection to assess how the service was managing medicines and if improvements had been made in relation to medicine management issues that we identified and raised at our inspection 14 August 2013.

We found patients received information about medicines in an appropriate way. We noted that medication reviews took place to ensure patients were prescribed their medicines appropriately.

Whilst we noted that controlled drug records had been provided, some recent records were incomplete. We identified that there were shortfalls in the security of medicines at the practice. Whilst we identified that the dispensary was adequately staffed by qualified persons who were being provided training and were assessed as competent there had been a series of dispensing errors where some patients had received medicines incorrectly. We found that the service is yet to implement a comprehensive and robust audit of its medicine management.

14 August 2013

During a routine inspection

We spoke with two people who visited the service during our inspection and four members of staff.

People told us the service was caring. One person told us, 'They always give you whatever time you need. That's why you don't mind waiting as you know when it's your turn you will get the time.' Another person told us, 'The doctors are always very sympathetic and are never short with you.'

People told us the service was effective and responsive to their needs. One person told us, 'They are extremely good at fitting you in in an emergency.' There were systems in place to ensure people were prompted to attend for chronic disease reviews and recommended health screening.

However, we found that not all policies and procedures were up to date. There was no infection control policy in place. The cleaning policy was not specific to the provider and did not ensure the risk of cross infection was properly managed. We also found procedures in place to ensure the safe dispensing of controlled drugs were not always followed.

We found there were no systems in place to identify, assess and monitor the risks to the health, safety and welfare of people. The analysis of incidents was not robust enough to ensure change happened to reduce the risk of the issue re-occurring in the future.