Abbeyview Surgery

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people were protected from abuse and avoidable harm. This is the first inspection for this service since its registration with CQC. This key question has been rated as requires improvement. We found a breach in regulation under safe care and treatment and as a result took enforcement action asking the practice to take appropriate actions within 3 months to meet the areas of improvement identified. We found all emergency medicines were not always available and where risk assessments were in place these did not give sufficient information around mitigation in place. We also found patients at risk of lack of appropriate monitoring and review of medicines, and poor management of blood pressure readings.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Feedback we received directly from patients was mixed. Patients did not always feel they were taken seriously. Patients found it difficult to access appointments. The practice had recently adopted an online triage system, AskMyGP, and they were developing how this worked for patients at the practice. Other providers of care who used the practice were positive of their relationship, especially highlighting the in-house pharmacy team, citing good communication and being responsive to requests.

Our review of patient records showed that medication reviews were not always comprehensive and they had not always involved patients and fully considered their needs.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Clinical records we saw did not always demonstrate care was provided in line with current guidance and patients were placed at potential risk. Patients did not always receive satisfactory medicines reviews. The practice developed their own action plan to address issues identified from the remote clinical searches but we are unable to assess the long term impact of this to ensure it is embedded for future management. Staff were encouraged to attend conferences and courses to improve their own learning and we saw some evidence that in house training was being developed to enhance workforce understanding of clinical topics.

Staff had access to the information they needed to appropriately assess, plan and deliver care. Other care providers told us communication between themselves and the practice was satisfactory. The practice had a good working relationship within their community and understood the needs of their population. Most staff told us they felt the team worked well together at the practice for the benefit of patients. At times, they felt communication could be improved but a recent change in management had seen an improvement in this area.

We saw inconsistent evidence of patient involvement in medication reviews, which were overdue and not always comprehensive. Remote clinical searches looking at medicines management highlighted that there were issues with appropriate monitoring taking place and that risks with specific medications were not always discussed with patients. The practice were passionate about engaging with their local community, organising an event which supported people to access other support they may need and was well received by those who attended. They offered health checks as part of events.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Remote clinical searches of the practice’s system showed outcomes were not always appropriate, with a lack of reviews, monitoring and follow ups taking place. Data available to us showed that some childhood immunisations uptake was below the national expected level.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. We saw examples where capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and made in line with relevant legislation. The practice carried out some minor surgery on site and consent gained was appropriate for this, with risks and benefits discussed with patients.