We carried out a review of the data available to us about Nettlebed Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Nettlebed Surgery, you can give feedback on this service.
In February 2016, during our previous comprehensive inspection of Nettlebed Surgery, we found issues relating to the safe delivery of healthcare services at this practice. As a result of this inspection, we asked the practice to make further improvements; in order to ensure that sharps are disposed of in the correct colour coded bags and bins. (Sharps refers to a medical term used for devices with sharp points or edges that can puncture the skin, for example needles).
We also found that the practice did not have a comprehensive risk assessment for the process of dispensing and delivering medicines to locations other than the practice. Furthermore, the practice had not carried out a legionella risk assessment and plan. The practice also needed to ensure that all staff had carried out appropriate training in infection control, and equality and diversity, and that all training was recorded. Finally at our previous inspection, we also found that the practice needed to implement a process for documenting that action plans for significant events have been carried out.
Following the last inspection, the practice was rated as requiring improvement in safe services, and good for effective, caring, responsive and well led services. The practice had an overall rating of good.
We carried out a desk based inspection in November 2016 to ensure the practice had made improvements since our last inspection. The practice sent us evidence in the form of letters to patients, a copy of a training matrix, evidence of their legionella risk assessment, and minutes from a significant events meeting, to demonstrate the range of improvements they had made, since our last visit. The practice also further supplied a chart outlining the areas the practice had attempted to improve. We found the practice had made improvements since our last inspection in February 2016.
At this inspection we found that:
The practice advised us that appropriate steps had been taken to ensure, that all sharps were disposed of in the correct colour coded bags and bins.
Following the last inspection, the practice had ceased the delivery of all medications to rural collection points.
The practice had produced a summary of their legionella risk assessment, and had provided evidence that this was now being followed.
The practice had a training matrix detailing the various courses staff had undertaken. The training matrix included infection control and equality and diversity training for all three GPs.
The practice had supplied minutes from a significant event meeting to demonstrate the learning in place for such events.
The areas where the provider should make improvements are:
Continue to improve the systems used to document training and significant events.
Ensure all members of staff receive equality and diversity training and clinical staff receive infection control training.
Following this desk based inspection we have rated the practice as good for providing safe services. The overall rating for the practice remains good. This report should be read in conjunction with the full inspection report of 17 February 2016. A copy of the full inspection report can be found at www.cqc.org.uk.
Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Nettlebed Surgery on 17 February 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
We saw one area of outstanding practice:
The areas where the provider must make improvements are:
The areas where the provider should make improvement are:
Professor Steve Field
CBE FRCP FFPH FRCGPChief Inspector of General Practice
Nettlebed Surgery is a GP practice located in the village of Nettlebed, Oxfordshire. The practice provides primary medical services to other major areas, which include Sonning Common, Checkendon, Stonor, Pishill and Assendons. The practice has over 3400 registered patients and is a dispensing practice providing dispensing services to 90% of their registered patients. The practice team consists of two GP partners, a salaried GP, three practice nurses, a dispenser, a practice manager and an administration team. This was the first inspection since registration.
The patients we spoke with were complimentary of the services they received from the practice. The feedback received through patient comment cards was also positive.
The practice provided services which were safe. Systems were in place for reporting and responding to incidents. All safety alerts were dealt with by the GPs and nurses and reception team. The practice had comprehensive safeguarding policies and procedures in place to protect vulnerable patients.
The practice provided services which were effective. Care and treatment to patients was delivered in line with recognised best practice. The practice achieved high results against the national Quality and Outcomes Framework (QOF), for 2012/13. These included the clinical, organisational, additional services and patient experience domains. The QOF was introduced in 2004 as part of the general medical services contract and is a voluntary scheme for GP practices in the UK. Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.
The practice was responsive to meeting patient’s needs. A range of clinics and services were offered to patients, which included family planning, antenatal, child immunisation and nurse specialist clinics for long-term conditions. Interpreters were used for patients who did not speak English. Patients we spoke with told us appointments were easy to arrange. Staff were caring and kind and treated patients with respect and dignity.
All staff demonstrated a caring approach. Patients were positive about the care they received. The practice had measures in place to preserve patient privacy and confidentiality.
The practice was well led. There was also clear evidence of accountability for clinical practice seen. The practice had appointed leads in various areas, such as safeguarding, infection control, clinical and information governance. The practice had achieved 100% score in the QOF results in 2012/13 for the patient experience domain.
The practice had systems in place to support specific population groups: older people, people with long term conditions, mothers with babies, children and young people, the working-age population and those recently retired, people in vulnerable circumstances who may have poor access to primary care, people experiencing mental health problems. Patients in all these groups were seen by the practice.
Home visits were arranged for frail and elderly patients. GPs and Nurses signposted elderly patients to various activities provided in the local village. The practice held regular clinics for long terms conditions such as diabetes and asthma. This was to ensure conditions were monitored to help manage symptoms and prevent long term problems. The practice ran various clinics to support the mothers, babies and young children patient group. These included antenatal care, family planning and child immunisation clinics. The practice supported patients who were not able to attend due to work commitments, by offering telephone advice. There were no barriers for patients in vulnerable circumstances. Patients wishing to register at the practice were always accepted. Home visits were provided to patients with mobility difficulties. Patients with mental health care needs had regular appointments with the practice nurse for tests to manage their medicines. The practice held regular counselling clinics.
The practice provides services from:
Nettlebed Surgery, Wanbourne Lane,
Nettlebed, Henley-On-Thames, Oxfordshire, RG9 5AJ.