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Inspection Summary


Overall summary & rating

Good

Updated 29 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Albany Surgery on 7 May 2015.

Overall the practice is rated as good.

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

Our key findings were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from incidents were taken advantage of.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group.

  • Patients had a variety of ways to make appointments and found the practice to be flexible in meeting their needs. We were told patients could always get an appointment.

  • The practice had good facilities and was well equipped to treat patients and meet their needs. Patients told us the practice was clean and safe.

The practice had a clear vision which had quality and safety as its first priority and high standards were promoted and owned by all practice staff with evidence of team working across all roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 29 October 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 patients safe.

Effective

Good

Updated 29 October 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 National Institute for Health and Care Excellence 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 appropriate training planned to meet these needs. There was evidence of appraisals and personal development plans for all staff. Staff worked well with multidisciplinary teams to plan and deliver patient care.

Caring

Good

Updated 29 October 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 was easy to understand. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

Responsive

Good

Updated 29 October 2015

The practice is rated as good for providing responsive services. They had reviewed the needs of the local population and engaged with the Clinical Commissioning Group to secure improvements to services where these were identified. Patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available on 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 evidence showed that the practice responded quickly to issues raised. Learning from complaints was shared and implemented with staff and other stakeholders.

Well-led

Good

Updated 29 October 2015

The practice is rated as good for being well-led. There was a clear vision and business strategy. Staff were clear about the vision and their responsibilities in relation to this. There was a well-defined leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings. There were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active in providing the practice with patient feedback. Staff had received inductions, regular performance reviews and attended staff meetings and learning events.

Checks on specific services

People with long term conditions

Good

Updated 29 October 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. The practice had a consistent approach to patients with chronic disease through close working between GPs and the practice nurse team. Clinic sessions were offered at varying times, to increase flexibility and enable patients to attend. Patients were involved in drawing up and agreeing their care plans. 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 medicine 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 29 October 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. We saw good examples of joint working with midwifery and health visitor teams and monthly multi-disciplinary meetings were held to discuss children on a protection plan, children in need and families of concern. The practice offered a full range of childhood immunisations in line with national guidance. Children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies.

Information relevant to young patients was displayed and health checks and advice on sexual health for men, women and young people included a full range of contraception services and sexual health screening including chlamydia testing and cervical screening.

Older people

Good

Updated 29 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for medical conditions commonly found in 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. Staff were responsive to the needs of older patients, and offered home visits and urgent appointments. The practice worked within the ‘1 care home, 1 practice’ model in Newton Abbot. The model allocated a designated GP who cared for the majority of residents in a care home which meant the GP was able to offer regular review visits and develop strong relationships with the residents, managers and staff. There was a carer identification process in place and the practice ensured that this group were informed about various types of support, both financial and practical which was available to them.

Working age people (including those recently retired and students)

Good

Updated 29 October 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 for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 29 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice employed a patient services manager that regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Patients experiencing poor mental health had also received an annual physical health check.

People whose circumstances may make them vulnerable

Good

Updated 29 October 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 people and those with a learning disability and offered longer appointments for people within these population groups. Patients with a learning disability were offered annual health checks.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.