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Reports


Review carried out on 17 December 2019

During an annual regulatory review

We reviewed the information available to us about West Coker Surgery on 17 December 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 1 November 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Coker Surgery (then known as Westlake Surgery) on 23 November 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for West Coker Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 1November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice and all population groups are now rated as good.

Our key findings were as follows:

  • Staff had a record of appropriate training relevant to their role, including up to date training in safeguarding adults, basic life support, fire safety and infection control.
  • There were effective arrangements in place to assess, monitor, manage and mitigate risks in respect of health and safety. These arrangements included systems for addressing Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts, reviewing patients’ medicines, the risk assessment of legionella; and a comprehensive business continuity plan was in place.
  • Arrangements for engaging patients with a learning disability and those diagnosed with a mental health condition were in place which ensured they had the appropriate care and support and attended annual reviews.
  • Systems were in place to assess, monitor and improve the quality and safety of the service, including those for up to date record keeping, including for staff training and for significant events; for a rolling programme quality improvement, such as clinical audits; and for engaging with patients, such as through a patient participation group.
  • Arrangements to identify and support carers were in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 23 November 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Lindsay Smith on 23 November 2016. Overall the practice is rated as requires improvement. The practice is rated as requires improvement for providing safe and effective services. The well led domain is rated as inadequate due to issues concerning overarching governance arrangements. The practice is rated as good for providing caring and responsive services.

Our key findings across all the areas we inspected were as follows:

  • Dr Smith supported around 1,800 patients and was one of two practices based in the shared Westlake Surgery premises. On 1 October 2016 the other individual provider in the premises retired and Dr Smith took on their patients. Westlake Surgery now supports approximately 3,900 patients and continues to operate the dispensary on site.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Risks to patients were assessed and managed, with the exception of those relating to some aspects of medicines management, staff training, record keeping and risk assessment for legionella.
  • Although some clinical audits had been carried out, there was no evidence that audits were driving improvements to patient outcomes.
  • The practice had a number of policies and procedures to govern activity, but some were overdue a review or were not in place at the time of inspection.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • There was a clear leadership structure and staff felt supported by management.

The areas where the provider must make improvement are:

  • Ensure that staff receive and have a record of appropriate training relevant to their role including up to date training in safeguarding adults, basic life support, fire safety and infection control.
  • Ensure there are effective arrangements in place to assess, monitor, manage and mitigate risks in respect of health and safety. These arrangements should also include systems for addressing Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts, reviewing patient’s medicines, the risk assessment of legionella and having in place a comprehensive business continuity plan.
  • Ensure the arrangements for engaging patients with a learning disability and those diagnosed with a mental health condition are implemented to ensure they have the appropriate care and support and attend annual reviews.
  • Ensure systems are in place to assess, monitor and improve the quality and safety of the service, including those for up to date record keeping, including for staff training and for recording significant events consistently and completing all actions; for a rolling programme quality improvement, such as clinical audits; and for engaging with patients, such as through a patient participation group.

The areas where the provider should make improvement are:

  • Review arrangements to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 16 May 2013

During a routine inspection

This was a planned inspection. However, as part of their registration process with us the provider Dr Lindsay Smith declared non compliance with two essential standards as they had no recruitment policy and staff had not received recent training in the protection of vulnerable adults. The provider told us of the steps they had taken to achieve compliance. At this inspection we found that the provider had taken appropriate action in relation to both of these areas.

We talked with patients who were visiting the practice on the day of our inspection and we also spoke with patients on the telephone to ask their view about the services provided to them in respect of their care, welfare and treatment. Patients told us staff were respectful and professional. One patient said �My doctor is kindness itself, he takes time with me and I feel I can ask him anything. I have been so worried about my health and didn�t want to be any trouble. His kindness has allowed me to discuss my fears and provide reassurances to me�.

People told us that all the staff they had met seemed competent, skilled and knowledgeable. One person said "I have confidence in my doctor. All of the staff here are a credit to the surgery and I have faith in them. They treat me with courtesy and respect, that�s all I could ask for�.

Patients said they felt confident if they had cause to complain this would be dealt with in an efficient professional manner.