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Inspection Summary


Overall summary & rating

Good

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We inspected this service on 31 October 2014 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

  • Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.

  • There were systems in place to keep patients safe from the risk and spread of infection.
  • Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.
  • The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 19 February 2015

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were enough staff to keep people safe.

Effective

Good

Updated 19 February 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were at or above average for the locality. Staff referred to guidance from the National Institute for Health and Care Excellence (NICE) and used it routinely. Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training appropriate to their roles and any further training needs had been identified and planned. The practice could identify all appraisals and the personal development plans for all staff. Staff worked with a number of multidisciplinary teams.

Caring

Good

Updated 19 February 2015

The practice is rated as good for providing caring services. Data showed that patients rated the practice higher than others for several aspects of care. Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

Information to help patients understand the services available to them was easy to understand. We also saw that staff treated patients with kindness and respect, and maintained confidentiality. We observed a patient-centred culture. Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieve this. We found many positive examples to demonstrate how patients’ choices and preferences were valued and acted upon.

Responsive

Good

Updated 19 February 2015

The practice is rated as good for providing responsive services. The practice had acted on suggestions for improvements and changed the way it delivered services in response to feedback from the patient surveys and from the patient participation group (PPG). A PPG is usually made up of a group of patient volunteers and members of the general practice team. The purpose of a PPG is to discuss the services offered and how improvements can be made to benefit the practice and its patients.

The practice reviewed the needs of its local population and engaged with the NHS Local Area Team (LAT) and Clinical Commissioning Group (CCG) to secure service improvements where these had been identified. CCGs are NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in England.

Patients told us they could get an appointment with a named GP or a GP of choice, with continuity of care and urgent appointments available the same day. The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand, and the practice responded quickly when issues were raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 19 February 2015

The practice is rated as good for being well-led. The practice promoted quality and safety as its top priority. All practice staff and teams worked together across all roles to achieve high standards. There was a high level of constructive engagement with staff and a high level of staff satisfaction. The practice gathered feedback from patients through a patient participation group (PPG). A PPG consists of patient volunteers who share their views and respond to surveys through the practice’s website. They comment about the services offered and how improvements can be made to benefit the practice and its patients.

Checks on specific services

Older people

Good

Updated 19 February 2015

The practice is rated as good for the care of older people. For example, we saw that the practice worked in a multi-disciplinary way to provide palliative care for patients. We saw that regular multi-agency meetings were held and recorded.

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia and end of life care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs.

People with long term conditions

Good

Updated 19 February 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All vulnerable 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 19 February 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 accident and emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations. 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 19 February 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 was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

People whose circumstances may make them vulnerable

Good

Updated 19 February 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 those patients at risk of harm or patients with a learning disability. The practice had carried out annual health checks and offered longer appointments for patients with learning disabilities.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had advised vulnerable patients about how to access various support groups and voluntary 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 normal working hours and out of hours.

People experiencing poor mental health (including people with dementia)

Good

Updated 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People 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. It carried out advanced care planning for patients with dementia.

The practice had advised patients experiencing poor mental health about how to access various support groups and voluntary organisations such as MIND which supports those with mental health problems. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.