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Inspection Summary


Overall summary & rating

Good

Updated 26 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Bridgeway Practice on 1 June 2015. We found that effective recruitment procedures were not in place. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirement to ensure effective recruitment procedures were followed in regards to all persons employed.

We undertook this focused inspection of the practice on 19 October 2015, to check that improvements had been made to meet the legal requirement following our comprehensive inspection. We looked at documents submitted to us by the practice, to demonstrate that they had taken action to address the issues we identified at the last inspection. We did not visit the practice as part of this review.

Overall the practice is rated as good. Our findings across the area we inspected were as follows:

  • Effective recruitment procedures were followed to help keep patients safe, and ensure that all staff employed are suitable to carry out the duties required of them.
  • Improvements had been made to ensure that the practice obtained all the information required by law, prior to new staff commencing employment, to ensure they are suitable to work with vulnerable adults and children.
  • An independent company provided up-to-date advice and support on all aspects of recruitment, employment law and human resources, to ensure that the practice followed robust procedures and met the legal requirements.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 26 November 2015

The practice is rated as good for providing safe services.

Robust recruitment procedures were followed to help keep patients safe, and ensure that all staff employed were suitable to carry out the duties required of them. Effective systems were in place to ensure that the practice obtained all the information required by law, prior to new staff commencing employment, to ensure they were suitable to work with vulnerable adults and children. An independent company provided up-to-date advice and support on all aspects of recruitment and employment law, to ensure the practice followed robust procedures and met the legal requirements. The induction checklist had been updated to ensure that new staff received essential information to carry out their work.

Effective

Good

Updated 26 November 2015

Caring

Good

Updated 26 November 2015

Responsive

Good

Updated 26 November 2015

Well-led

Good

Updated 26 November 2015

Checks on specific services

People with long term conditions

Good

Updated 23 July 2015

The practice is rated as good for the care of people with long-term conditions. The nurse had lead roles in chronic disease management and patient reviews. Patients were offered an annual health review including a review of their medicines. They also had a named GP to ensure their needs were being met. When needed, longer appointments and home visits were available. Patients with long term conditions and other needs were reviewed at a single appointment where possible, rather than having to attend various reviews.

Patients were educated and supported to self-manage their conditions. The practice kept a register of patients with complex needs requiring additional support, and worked with relevant professionals to meet their need. Carers were identified and supported to care for people with complex long-term conditions.

Families, children and young people

Good

Updated 23 July 2015

The practice is rated as good for the care of families, children and young people. Priority was given to appointment requests for babies and young children. Systems were in place for identifying and following-up children at risk of abuse, or living in disadvantaged circumstances. The practice worked in partnership with midwives, health visitors and school nurses to meet patients’ needs. The 2013 to 2014 data for all childhood immunisations showed that most standard immunisation rates for children up to 2 years of age were good, although several immunisation rates for pre-school aged children were below the local Clinical Commissioning Group average. A robust action plan had been put in place to bring about the necessary improvements.

Children were able to attend appointments outside of school hours. The practice provided maternity care and certain family planning services. The practice also provided advice on sexual health for teenagers.

Older people

Good

Updated 23 July 2015

The practice is rated as good for the care of older people. Patients over 75 years were invited to attend an annual health check, and had a named GP to ensure their needs were being met. The practice worked closely with other services to enable patients to remain at home, where possible. The practice was signed up to an enhanced service to avoid unplanned admissions into hospital, and had identified older patients who were at risk of admissions. Care plans had been developed for such patients, which were kept under review.

Flu, pneumococcal and shingles immunisations were actively offered to patients. It was responsive to the needs of older people, and offered home visits to patients unable to attend the practice. Carers were identified and supported to care for older people.

Working age people (including those recently retired and students)

Good

Updated 23 July 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Patients were offered telephone consultations and were able to book non-urgent appointments around their working day by telephone or on line. Extended appointment hours were offered until 7.45 pm on Monday, which was helpful for patients of working age. The practice offered a ‘choose and book’ service for patients referred to secondary services. This provided greater flexibility over when and where their test took place, and enabled patients to book their own appointments.

NHS health checks were offered to patients aged 40 to 74 years, which included essential health checks and screening for certain conditions. The practice also offered health promotion and screening appropriate to the needs of this age group

People experiencing poor mental health (including people with dementia)

Good

Updated 23 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of patients experiencing poor mental health. Patients were offered extended or same day appointments or telephone consultations. When needed, longer appointments and home visits were available. Patients were invited to attend an annual health review, and had an allocated GP to ensure their needs were being met. The practice worked with mental health services to ensure that appropriate risk assessments and care plans were in place, and that patients’ needs were regularly reviewed.

Patients were supported to access emergency care and treatment when experiencing a mental health crisis. The practice was signed up to provide enhanced services for patients with dementia, and screened patients to help facilitate early referral and diagnosis where dementia was indicated.

People whose circumstances may make them vulnerable

Good

Updated 23 July 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 people with learning disabilities. Patients were offered extended or same day appointments or telephone consultations. Several appointments were made available each day specifically for vulnerable patients or those at risk of admission to hospital. Patients were also invited to attend an annual health review, and had an allocated GP to ensure their needs were being met.

The practice worked with relevant services to ensure vulnerable people received appropriate care and support. Patients were told about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. They were aware of their responsibilities to share information, record safeguarding concerns and how to contact the relevant agencies.