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Inspection Summary


Overall summary & rating

Good

Updated 9 February 2018

Letter from the Chief Inspector of General Practice

Enys Road Surgery was previously inspected in August 2015 and was rated good in all domains and overall.

At this inspection in December 2017 the practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Enys Road Surgery on 18 December 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • The practice operated a ‘traffic light’ system for patients who were high risk and needed a prompt response if they requested help.

  • They practice offered an afternoon walk-in service for registered patients with urgent concerns.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • The practice encouraged patient feedback and responded positively to patient needs.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice taught external practitioners from several clinical disciplines and encouraged learning and improvement within their own staff.

The areas where the provider must make improvements as they are in breach of regulations are:

Establish effective systems and processes to ensure that care and treatment is provided in a safe way for service users. By:-

  • Ensuring that the fire risk assessment is updated and all actions taken recorded.

  • Ensuring all outstanding electrical work is completed.

The areas where the provider should make improvements are:

  • Review how GP registration is recorded and monitored on an ongoing basis.

  • Consider having a GP check prescriptions issued, but not picked up by patients before destroying them.

  • To adhere to the recruitment policy on all occasions.

  • Review the low uptake of pneumococcal booster vaccine for children aged two.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Requires improvement

Updated 9 February 2018

Effective

Good

Updated 9 February 2018

Caring

Good

Updated 9 February 2018

Responsive

Good

Updated 9 February 2018

Well-led

Good

Updated 9 February 2018

Checks on specific services

Older people

Good

Updated 23 April 2015

The practice is rated as good for the care of older patients. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice provided support to high numbers of older patients in the local population. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people and offered home visits and rapid access appointments for those with enhanced needs.

People with long term conditions

Good

Updated 23 April 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 23 April 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Working age people (including those recently retired and students)

Good

Updated 23 April 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice provided regular services to students within the local university. The practice provided Chlamydia testing kits and participated in the C card scheme to support patients’ sexual health. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

People whose circumstances may make them vulnerable

Good

Updated 23 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including homeless patients, those who were housebound and those with a learning disability. Annual health checks were provided for patients with a learning disability. The practice offered longer appointments for patients with learning disabilities.

The practice worked closely with district nurses and the community matron which enabled an improved continuity of care for their housebound patients. The practice had identified those housebound patients who had not recently engaged with the practice in order to improve the level of care provided to this vulnerable group. Protected time had been made available to enable practice nurses to provide home visits to these patients. The practice regularly worked with multi-disciplinary teams in the case management of adults and children who were vulnerable. The practice had sign-posted these patients to various support groups and voluntary sector organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours. However, many staff had not received training in the safeguarding of vulnerable adults.

People experiencing poor mental health (including people with dementia)

Good

Updated 23 April 2015

The practice is rated as good for the care of patients experiencing poor mental health (including people with dementia). Those patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice carried out advanced care planning for patients with dementia.