Falklands Surgery - Care Quality Commission

Background to this inspection

Updated 17 October 2017

Falklands surgery is situated in Bradwell, Great Yarmouth and provides a service to patients in Bradwell, Gorleston and the surrounding villages. The practice holds a General Medical Service (GMS) contract with the local Clinical Commissioning Group (CCG) and offers health care services to approximately 7100 patients.

The building provides good access with accessible toilets and car parking facilities for disabled patients. Patients using the practice also have access to community staff including the community matron, district nurses, community psychiatric nurses, health visitors, support workers, health visitors and midwives.

Falklands surgery was previously provided by a GP partnership. In January 2016, Falklands surgery formed a partnership with East Coast Community Healthcare Community Interest Company (ECCH), who are now the provider for the practice. ECCH is a provider of over 30 community services, which includes four GP practices and has been established for five years. Staff employed by Falklands surgery were due to transfer their employment to ECCH, however there had been delays with this. Falklands Surgery are now planning to form a partnership with a different provider, so the employment of the staff has remained with Falklands Surgery.

The practice has a team of two GPs (two male) meeting patients’ needs. In addition, there is one nurse practitioner, a senior practice nurse, three practice nurses, two healthcare assistants and a primary care practitioner. Three of the nurses hold a prescribing qualification. There is a practice manager and a team of administration and reception staff, and an information officer.

The practice has less patients aged 0 to 18 years and more patients aged over 65 years compared to the CCG and England averages. Income deprivation affecting older people is similar to the CCG and England average. Male and female life expectancy in this area is in line with the England average at 79 years for men and 83 years for women.

The practice is open between 8am and 6.30pm Monday to Friday and appointments are available from 8.30am to 5.45pm. If the practice is closed Integrated Care 24 provide the out of hours service, patients are asked to call the NHS111 service to access this service or to dial 999 in the event of a life threatening emergency.

Overall inspection

Good

Updated 17 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Falklands Surgery on 26 April 2017. The overall rating for the practice was requires improvement, with requires improvement for providing safe and well led services and good for providing effective, caring and responsive services. The full comprehensive report on the 26 April 2017 inspection can be found by selecting the ‘all reports’ link for Falklands Surgery on our website at www.cqc.org.uk.

We undertook a focused inspection on 4 October 2017 to check they had followed their action plan and to confirm they now met legal requirements in relation to the breaches identified in our previous inspection on 26 April 2017. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good overall, and good for providing safe and well led services.

Our key findings from this inspection were as follows:

Falklands Surgery is a partnership with East Coast Community Healthcare Community Interest Company (ECCH). At the time of this inspection, Falklands Surgery were planning to form a partnership with a different provider. Therefore, actions to share the ECCH visions and values with staff and attendance at ECCH senior management meetings had not been completed, as this was not felt to be appropriate due to the imminent partnership changes. Staff had been informed of the planned changes and told us they felt supported at this time of change.
There were effective governance processes in place to identify, act on, monitor and review health and safety risks to patients and staff that were identified, including those that related to legionella, significant events and calibration testing.
Staff had been trained in safeguarding children and vulnerable adults to a level appropriate to their role. Two members of non clinical staff who had joined the practice recently were due to complete safeguarding training and we saw evidence that the practice were monitoring the completion of this training.
Information technology systems had improved so the practice could ensure ECCH was informed of all significant events and staff were able to complete mandatory e-learning training.
Improvements have been made in relation to annual health checks for people with a learning disability registered at the practice. Staff had worked with a learning disability nurse and letter templates for patients had been agreed, although the practice planned to invite patients by telephone and then send a letter. The practice planned to offer a 30 minute appointment with a nurse, followed by a 30 minute appointment with a GP to complete the annual health check. Patients had been identified and were scheduled to be called according to their month of birth. The number of patients who had received a health check in the previous 12 months was 15 out of 30 patients, which was the same number as the inspection on 26 April 2017. However the practice advised that all patients would have been offered and received a health check by March 2018.
Significant improvements had been made to the percentage of staff who had completed training deemed mandatory by the provider ECCH and who had received an appraisal.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice