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Inspection carried out on 13 December 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 25 February 2015 – Good).

The key questions are rated as:

Are services safe? – Good

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 Southwell Medical Centre on 13 December 2017 as part of our inspection programme.

At this inspection we found:

  • Some of the systems in place to support the appropriate and safe handling of medicinesrequired review and improvement.

  • Significant events and incidents were appropriately identified, recorded and acted on. When any incidents happened, the practice learned from them, improved their processes and ensured staff relevant information was shared with staff.

  • There was a consistent approach to quality and improvement within the practice, which brought about positive changes. This included using audits to help drive improvement and evidence of reflective learning as a result of these.

  • End of life care was delivered in a coordinated way with detailed care plans in place to describe the needs and care arrangements for each of these patients and help ensure that their wishes were respected.

  • The practice supported a nearby university campus and were very proactive in this. They encouraged new students to register as patients and liaised with the university student support team to ensure that they were aware of any particular health issues for this patient group.

  • Patients felt staff were very professional, helpful and caring and could access appointments or other support from the practice when they needed to.

  • Results from the latest national GP patient survey showed that the practice was in line with local and national averages across all questions about patient experience.

  • There was strong clinical leadership which impacted positively upon the quality of the service.

  • Staff throughout the practice felt well supported and able to raise any concerns. They had confidence that any worries they had would be listened to and acted on.

  • The views and concerns of patients and staff were encouraged, heard and acted on to help improve services

  • The practice had an active, well organised patient participation group (PPG) which played a key role in representing the views of patients and helping to improve the services offered by the practice.

The areas of practice where the provider should make improvement are;

  • Implement the practice recruitment policy reliably so that all appropriate checks are completed when staff are recruited.

  • Review arrangements for the receipt and review of all safety alerts to be able to demonstrate appropriate action is taken to protect patients from risk.

  • Consider how to best support a greater proportion of patients with a learning disability to access an annual review of their health needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 25 February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Southwell Medical Centre on 25 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, and responsive services. We found the practice was outstanding for providing caring services. It was also providing good services for all population groups.

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.
  • 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.

We saw areas of outstanding practice, including:

  • The practice provided outstanding support to patients receiving end of life care and their relatives and carers. Support following bereavement was also outstanding. We saw that GP's provided contact details to patients nearing the end of their life to ensure they had access to a GP who knew them out of hours to ensure continuity of care.
  • The practice had robust safeguarding procedures, particularly for children including well established strong links with other safeguarding agencies. They always attended child protection meetings in person.
  • The practice had identified that students did not access GP services well. To address this, the practice manager attended fresher’s week at the nearby university site to advise students how best to use the practice. The location of the university site was very isolated and the practice had identified that students could experience poor mental health as a result. They had therefore developed strong links with the mental health support team to offer help advice and early intervention.
  • The practice provided caring and responsive medical care to a respite home for children and young people with physical and learning disabilities. Including GP's working late to ensure the residents had access to care and treatment when needed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

CQC Insight

These reports bring together existing national data from a range of indicators that allow us to identify and monitor changes in the quality of care outside of our inspections. The data within the reports do not constitute a judgement on performance, but inform our inspection teams. Our judgements on quality and safety continue to come only after inspection and we will not make judgements on data alone.