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Inspection Summary


Overall summary & rating

Good

Updated 31 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Surgery on 26 September 2016. Overall the practice is rated as good.

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

  • The practice was rated 91st out of 7,788 practices in a national patient survey of GP practices.
  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The practice had strong and visible clinical and managerial leadership and governance arrangements.
  • Patients said they usually found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • Feedback from patients about their care was consistently positive.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 31 October 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.
  • Lessons were shared to make sure action was taken to improve safety in the practice.
  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 31 October 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were usually average for the locality and compared to the national average.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 31 October 2016

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice above average with others for all aspects of care.
  • 100% of patients said they had confidence and trust in the last GP they saw.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • Feedback from patients about their care and treatment was consistently positive.

Responsive

Good

Updated 31 October 2016

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.

  • 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.

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 31 October 2016

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients.
  • There was a clear leadership structure and staff felt supported by management.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.
  • The patient participation group was active.
Checks on specific services

People with long term conditions

Good

Updated 31 October 2016

The practice is rated as good for the care of people with long-term conditions.

  • Nursing staff had lead roles in chronic disease management.
  • Longer appointments and home visits were available when needed.
  • The practice nurse carried out weekly home visits to housebound patients with long term conditions.
  • All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.
  • For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 31 October 2016

The practice is rated as good for the care of families, children and young people.

  • There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were in line with other practices for all standard childhood immunisations.
  • Patients told us that children and young people were treated in an age-appropriate way.
  • All children under the age of five were seen on the day the appointment request was made.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.

Older people

Good

Updated 31 October 2016

The practice is rated as good for the care of older people.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.
  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs including home visits for acute problems and in order to provide seasonal vaccines.
  • The practice held monthly multi-disciplinary team meetings where other clinicians such as district nurses attended.

Working age people (including those recently retired and students)

Good

Updated 31 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

  • The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
  • Appointments were available from 8am Monday to Friday and telephone appointments were also available.
  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 31 October 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

  • 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG average of 83% and the national average of 84%.

  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
  • The practice carried out advance care planning for patients with dementia.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 31 October 2016

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 those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability and offered a range of visual information leaflets and letters.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.