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Inspection Summary


Overall summary & rating

Good

Updated 4 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection report published 7 January 2016 - Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Andaman Surgery on 15 November 2017 as part of our regulatory functions.

At this inspection we found:

  • The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines. The clinical team met regularly to keep updated, share learning and review patients. Support and monitoring was in place for the nursing staff, although the monitoring of the work undertaken by the nurse practitioner was primarily informal.
  • The practice engaged with the Clinical Commissioning Group and worked with a group of local practices to improve the service for patients.
  • Staff involved and treated people with compassion, kindness, dignity and respect. All staff had received equality and diversity and dementia awareness training.
  • Patients found the appointment system easy to use and reported that they were able to access care at the right time. Patient feedback on access to appointments was positive, this was supported by a review of the appointment system and data from the latest national GP Patient Survey.

  • Information on the complaints process was available for patients at the practice and on the practice’s website. There was an effective process for responding to, investigating and learning from complaints. Responses to patients were timely, however they did not all detail information about the Parliamentary and Health Service Ombudsman.
  • Staff told us they were happy to work at the practice, received training for their role and were encouraged to raise concerns and share their views.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice was a training practice for qualified doctors training to become GPs.

The areas where the provider should make improvements are:

  • Review the work undertaken by the nurse practitioner to obtain assurance of the quality of their work.
  • Continue to engage with the local Clinical Commissioning Group in relation to improving performance on antibiotic prescribing and radiology referral rates.
  • Information about the Parliamentary and Health Service Ombudsman should be included in all complaint response letters.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 4 December 2017

Effective

Good

Updated 4 December 2017

Caring

Good

Updated 4 December 2017

Responsive

Good

Updated 4 December 2017

Well-led

Good

Updated 4 December 2017

Checks on specific services

People with long term conditions

Good

Updated 7 January 2016

The practice is rated as good for the care of patients with long term conditions. The practice held a register of patients with poor mental health and other long-term conditions. They held regular multidisciplinary meetings with other healthcare professionals to plan and coordinate care and treatment. Patients with diabetes, respiratory and heart conditions received regular reviews of their condition by clinical staff and patients details were shared where appropriate with community teams. Patients with palliative care needs were allocated a named GP who was responsible for their on-going care and support needs and the practice worked within a nationally agreed framework.

Families, children and young people

Good

Updated 7 January 2016

The practice is rated as good for the care of families, children and young people. The practice had a policy where childhood immunisation could be carried out during a routine appointment. The appointment system met the needs of families, children and young people. The practice had a designated child safeguarding lead who worked closely with the health visiting team. Regular safeguarding meetings were held at the practice and concerns cascaded to staff at weekly practice meetings. 

Older people

Good

Updated 7 January 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. There were home visits available for patients which were housebound. Consulting rooms were all available for patients with limited mobility, there was a lift available if access to the first floor was needed. There were a range of enhanced services delivered in the practice and available for patients. All patients we spoke with stated their care was considered, compassionate and appropriate for their needs.  We saw follow up appointments arranged if the patient had been an emergency admission to hospital and close working with community teams.

Working age people (including those recently retired and students)

Good

Updated 7 January 2016

The practice is rated as good for the care of the working age population. Appointments could be booked in advance. Patients could see a GP of their choice and this provided continuity of care.  The practice offered a choose and book service for patients being referred to secondary care. NHS Health checks were offered to patients between the ages of 40 and 74 with no pre-existing long term health conditions. 

People experiencing poor mental health (including people with dementia)

Good

Updated 7 January 2016

The practice is rated as good for the care of people experiencing poor mental health. Patients experiencing poor mental health were offered an annual review of their physical and mental health needs. Patients were supported to access emergency care and treatment when experiencing a mental health crisis. The practice showed an on-going commitment to staff training and development in respect of mental health. The practice had a designated adult safeguarding lead and a communications strategy to ensure patients were protected. 

People whose circumstances may make them vulnerable

Good

Updated 7 January 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of vulnerable patients including those with a learning disability. It had carried out annual health checks for people with a learning disability and these patients had a personalised care plan in place. It offered longer appointments for patients that needed them.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had advised vulnerable patients how to access various support groups and voluntary organisations.