This practice is rated as Good overall. (Previous inspection July 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Good
We carried out an announced inspection at Greystoke Surgery on 8 June 2018 as part of our inspection programme.
At this inspection we found:
- The practice had systems to keep patients safe and safeguarded from abuse.
- The practice routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
- Outcomes for patients were consistently better than expected.
- Staff involved and treated patients with compassion, kindness, dignity and respect. Patient feedback was very positive.
- The practice organised and delivered services to meet patients’ needs. They took account of patients’ needs and preferences.
- Patients could access services and appointments in way and at a time that suited them.
- There was a focus on continuous learning and improvement at all levels of the organisation. The practice proactively used performance information to drive improvement.
- The practice had some systems to manage risk so that safety incidents were less likely to happen. However, arrangements for managing and monitoring infection control processes required improvement.
- Some staff training was incomplete; this included training on infection control, fire safety and CPR updates.
We saw some areas of outstanding practice:
- The practice had effective arrangements in place to monitor patients to ensure they received the right care and treatment. Outcomes for patients were consistently good; the practice achieved high scores in the Quality and Outcomes Framework and had a very low exception rate; uptake rates for breast and bowel cancer screening were well above average; childhood immunisation rates and cervical screening rates were very high.
- The practice offered annual health checks to patients with a learning disability. Following this a written care plan was agreed and sent to the patient; 92% of the 37 patients on the register had agreed care plans in place.
- A new appointments system had been introduced in 2017 which provided same day access for patients. This system enabled appointments and telephone calls to be arranged for a convenient time for the patient. The lengths of each appointment were tailored to the needs of the patient and the complexity and/or number of health issues to be covered. Data showed that this approach increased the number of appointments available (by 18%) and reduced the DNA (did not attend) rate (by 83%).
The areas where the provider should make improvements are:
- Carry out regular infection control audits to ensure appropriate standards are being maintained.
- Take steps to provide staff with appropriate training on infection control, fire safety and CPR.
- Develop a system to increase identification of patients who are also carers.
- Carry out the remaining appraisals for administrative staff.
- Review staff’s professional registration status on a regular basis to obtain assurance they remain appropriately registered.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice