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Reports


Review carried out on 2 April 2020

During an annual regulatory review

We reviewed the information available to us about Poole Town Surgery on 2 April 2020. 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 09/01/2020

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Poole Town Surgery on 23 January 2019. The overall rating for the practice was good. However, the practice was rated requires improvement for providing well-led services. A Requirement Notice was served in relation to a breach of Regulation 17 Good Governance, The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report for the inspection undertaken on the 23 January 2019 can be found by selecting the ‘all reports’ link for Poole Town Surgery on our website at .

After our inspection on 23 January 2019 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the Requirement Notice.

This inspection was an announced focussed follow-up inspection carried out on 9 January 2020 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 on 23 January 2019. This report only covers findings in relation to those requirements.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

This practice remains rated as good overall. The practice is now rated as good for providing well-led services.

At this inspection we found:

• The practice showed that all learning from significant events had been shared with all relevant staff.

• All staff had completed training in safeguarding adults and children to the appropriate level.

• The arrangements for identifying, recording and managing risks were effective. There were effective recruitment checks, fire alarm tests and records of staff vaccination status. There was effective management of prescription security.

• The provider was aware that some Quality and Outcomes Framework (QOF) exception reporting was higher than national averages and had taken steps to address the level of exception reporting.

The areas where the provider should make improvements are:

• Continue to monitor Quality and Outcomes Framework (QOF) exception reporting and continue to implement appropriate measures to reduce this in line with local and national data.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated

Care

During a routine inspection

We carried out an announced comprehensive inspection at Poole Town Surgery on 23 January 2019.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We rated the practice as Requires Improvement for providing well-led services because:

  • The overall governance arrangements were ineffective.
  • The practice did not have clear and effective processes for identifying potential risks.

We rated the practice as Good for providing safe, effective, caring and responsive services because:

  • The practice had employed a health care assistant (HCA) specifically to support patients who were living with frailty.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • A total of 137 patients were identified as carers; this represented approximately 4% of the practice list.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way. This was reflected unanimously in the patient feedback we received.

We rated all population groups as Good, with the exception of long-term condition which was rated as Requires Improvement.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review documentation of weekly fire alarm tests.
  • Review systems to promote cervical screening uptake.
  • Review systems to accurately reflect completion of mandatory training.
  • Review storage of prescription stationery.
  • Review systems for sharing learning from significant events with all relevant staff.
  • Review recruitment polices to reflect arrangement to assure the provider of an employee’s previous conduct and document staff vaccination status.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Inspection carried out on 2 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Poole Town surgery on 2 December 2015. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that 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.
  • 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 provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

The practice had initiated a project to provide better care for older people specifically those over 75 years of age. They had employed a health care assistant (HCA) specifically for this and increased their nursing hours to allow them to have one session a week in the community visiting their over 75’s. This gave the practice the flexibility to see patients who either found it difficult to get into the practice or did not meet the criteria for visits from the district nursing team. Staff were able carry out routine health checks, observe the patient in their own environment and pick up any early signs that they were not coping. Care plans would be put in place where issues had been identified. The practice were able to give us examples of where admission to hospital had been avoided as symptoms had been recognised and treated before hospitalisation was required

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice