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The Barcellos Family Practice Good

Inspection Summary

Overall summary & rating


Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of Corbin Avenue Surgery on 28 June 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at Corbin Avenue Surgery on 14 January 2016 when we rated the practice as good overall. The practice was rated as requires improvement for providing safe care. This was because of how the fridge temperatures that stored vaccines were managed.

We asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time. The practice was able to demonstrate that they were meeting the standards. The practice is now rated as good for providing safe care. The overall rating remains as good.

This report should be read in conjunction with the full inspection report dated 14 January 2016.

Our key finding across the area we inspected was as follows:

  • There was an open and transparent approach to safety and an effective system in place for the management and monitoring of fridge temperatures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas



Updated 18 July 2016

The practice is rated as good for providing safe services.

There were safe and effective systems in place:

  • For the management of vaccine fridge temperatures.



Updated 21 March 2016

The practice is rated as good for providing effective services.

  • Data showed patient outcomes were at or above average for the locality.

  • 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 multidisciplinary teams to understand and meet the range and complexity of patients’ needs.



Updated 21 March 2016

The practice is rated as good for providing caring services.

  • Data showed that patients rated the practice higher than others for several aspects of care.

  • 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 also saw that staff treated patients with kindness and respect, and maintained confidentiality.

  • The practice did not have a high number of patients registered who had English as a second language. However, these patients were not routinely offered translation services to assist with appointments.



Updated 21 March 2016

The practice is rated as good for providing responsive services.

  • It 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 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.

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



Updated 21 March 2016

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

  • It had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to this.

  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.

  • 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 practice had systems in place for identifying notifiable safety incidents.

  • The practice proactively sought feedback from staff and patients, which it acted on.

  • There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions


Updated 21 March 2016

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

  • Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

  • Overall performance for diabetes related indicators was better than the CCG and national averages. The practice achieved 100% compared to a CCG average of 95% and a national average of 89%.

  • Longer appointments and home visits were available when needed.

  • All these patients had a named GP and a structured annual review to check that 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.

  • The practice ran joint clinics with a diabetes specialist nurse from the local hospital on a regular basis. This was for patients with uncontrolled diabetes or those who were newly diagnosed. The practice used a standardised template for each long-term condition to record information to improve continuity of care.

Families, children and young people


Updated 21 March 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 accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.

  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

  • The practice’s uptake for the cervical screening programme was 79% which was comparable to the national average of 82%.

  • A full range of sexual health and family planning services were offered by the practice.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • We saw good examples of joint working with midwives, health visitors and school nurses.

Older people


Updated 21 March 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. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice has implemented a ‘Tracker Team’ in June 2015, which consisted of a lead GP, a nurse and an administrator. The role of this team was to look after patients who are over 75 years old plus any other vulnerable adult patients. Each patient on this register had a care plan. The team put in place any necessary and appropriate services and maintained regular contact with both the patient and any carers until such time that the service was no longer required. Practice data from June to November 2015, suggested that emergency admissions in this age group had been reduced by 9%, compared to the same time period in the previous year. Practice data also suggested that since the tracker team, end of life wishes were more proactively being discussed with patients. 75% of patients in this age group had their wishes with regard to resuscitation recorded in their notes, compared to 38% the previous year.

The practice proactively highlighted other services which may be appropriate for this group. For example, during flu vaccination clinics, the Dorset Fire Service and the local Wayfinders (a signposting and support service for older people) are invited to also attend to give advice to patients.

Working age people (including those recently retired and students)


Updated 21 March 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.

  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)


Updated 21 March 2016

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

  • Overall performance for mental health related indicators was above the CCG and national average. The practice achieved 100%, compared to a CCG average of 92% and a national average of 88%.

  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

  • It 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.

  • There was a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable


Updated 21 March 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 homeless patients, travellers and those with a learning disability.

  • It offered longer appointments and annual reviews for patients with a learning disability.

  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

  • It had told vulnerable patients about how to access various support groups and voluntary organisations.

  • 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.

The practice had a ‘vulnerable adult’ nurse who worked alongside the doctors. The nurse monitored vulnerable patients on a recall system. The nurse maintained close contact with them and their carers to assess their needs and to get the right services in place for them. Any member of staff, including support staff who may notice changes in behaviour, was able to refer a patient to the nurse for an assessment and support.