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Inspection Summary


Overall summary & rating

Good

Updated 30 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Riversdale Surgery on 15 November 2016. The overall rating for the practice was good. However, we rated the practice as requires improvement for providing safe services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Riversdale Surgery on our website at www.cqc.org.uk.

We carried out an announced focused inspection on 30 May 2017, to confirm the practice had carried out their plan to meet the legal requirement in relation to the breach in regulation that we had identified in our inspection, on 15 November 2016. This report covers our findings in relation to that requirement.

Overall the practice is rated as good. Our key findings from this inspection were as follows:

  • The provider had complied with the requirement notice we set following our previous inspection visit. In particular, we found that there were suitable arrangements for the proper and safe management of medicines, and these helped to make sure care and treatment was provided to patients in a safe way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 30 June 2017

The practice is rated as good for providing safe services.

  • Since our previous inspection, the provider had taken action to address the breach of legal requirement we found during our previous inspection. For example, the Patient Specific Directives and Patient Group Directions we checked complied with national guidance. Staff followed the practice’s policy for ensuring medicines were stored at the required temperatures and prescription pads were stored securely, in line with national guidance.

Effective

Good

Updated 30 June 2017

Caring

Good

Updated 30 June 2017

Responsive

Good

Updated 30 June 2017

Well-led

Good

Updated 30 June 2017

Checks on specific services

People with long term conditions

Good

Updated 24 January 2017

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

  • The QOF data, for 2014/15, showed the practice had performed above most local CCG and national averages, in relation to providing care and treatment for the majority of the clinical conditions commonly associated with this population group. (Just before we published the report, the QOF data for 2015/16 was released. This showed that the practice had maintained an equally high level of QOF performance.)

  • Patients with long-term conditions were invited to attend a chronic disease review, at a frequency which reflected their needs. There were effective systems in place which helped to ensure that patients who failed to respond to an invitation to attend a healthcare review were contacted and encouraged to attend. The practice had been proactive in providing the shingles and influenza immunisations to at-risk age groups, and they had achieved a high level of performance in both of these areas.

  • Clinical staff were good at working with other healthcare professionals to meet the needs of patients with complex needs. Patients at risk of an emergency hospital admission were identified as a priority, and their needs were regularly reviewed at multi-disciplinary meetings.

Families, children and young people

Good

Updated 24 January 2017

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

  • There were appropriate systems in place to protect children who were at risk and living in disadvantaged circumstances. For example, monthly meetings took place involving the community midwife, health visitors and school nurses, to help identify potential safeguarding issues and manage risk. Appointments were available outside of school hours and ill children were provided with access to same day care. The premises were suitable for children and babies.

  • The practice offered contraceptive and sexual health advice. Information was available, about how patients could access specialist sexual health services.

  • The practice had a comprehensive screening programme, and had performed above the national averages in relation to breast, bowel and cervical screening. For example, the uptake of cervical screening, for females aged between 25 and 64, who attended during the target period, was higher, at 88.3%, than the national average of 81.8%.

  • The practice offered a full range of immunisations for children. Publicly available information showed the practice had performed above the local CCG averages in delivering these immunisations. For example, childhood immunisation rates, for the vaccinations given to children under two years old, ranged from 92.7% to 98.2% (the local CCG averages ranged from 73.3% to 95.1%). For five year olds, the rates ranged from 96.2% to 98.1% (the local CCG averages ranged from 81.4% to 92.9%).

Older people

Good

Updated 24 January 2017

The practice is rated as good for older people.

  • Nationally reported Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed above most local clinical commissioning group (CCG) and national averages, in relation to providing care and treatment for the clinical conditions commonly associated with this population group. (Just before we published the report, the QOF data for 2015/16 was released. This showed that the practice had maintained an equally high level of QOF performance).

  • The practice offered proactive, personalised care which met the needs of older patients. For example, all patients over 75 years of age had a named GP who was responsible for their care.

  • Staff worked in partnership with other health care professionals to ensure that older patients received the care and treatment they needed. The practice team actively participated in the local High Risk Patient Pathway, to help reduce unplanned admissions into hospital. They also participated in regular multi-disciplinary meetings where the needs of high risk patients were discussed, and plans put in place to meet their needs.

Working age people (including those recently retired and students)

Good

Updated 24 January 2017

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

  • The practice was proactive in offering online services, as well as a full range of health promotion and screening that reflected the needs of this group of patients. Patients were able to use on-line services to access appointments and request prescriptions. Same day face-to-face appointments, and telephone consultations were provided, as was access to on-the-day emergency appointments.

  • The QOF data showed the practice had performed above most of the local CCG and England averages, in providing recommended care and treatment to this group of patients. (Just before we published the report, the QOF data for 2015/16 was released. This showed that the practice had maintained an equally high level of QOF performance.)

People experiencing poor mental health (including people with dementia)

Good

Updated 24 January 2017

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

  • The QOF data, for 2014/15, showed the practice had performed above the local CCG and national averages, in relation to providing care and treatment to this group of patients. (Just before we published the report, the QOF data for 2015/16 was released. This showed that the practice had maintained an equally high level of QOF performance.)

  • The practice’s clinical IT system clearly identified patients with dementia and mental health needs, to ensure staff were aware of their specific needs.

    These patients were invited to attend an annual health review.

  • Patients experiencing poor mental health had access to information about how to contact various support groups and voluntary organisations.
  • Clinical staff actively carried out opportunistic dementia screening, to help ensure their patients were receiving the care and support they needed to stay healthy and safe.

  • Staff had completed Dementia training, which helps to raise awareness of dementia related issues.

People whose circumstances may make them vulnerable

Good

Updated 24 January 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

  • There were suitable arrangements for meeting the needs of vulnerable patients. The practice maintained a register of patients with learning disabilities, which was used to help ensure they received an annual healthcare review.

  • Systems were in place to protect vulnerable children from harm. Staff understood their responsibilities regarding information sharing and the documentation of safeguarding concerns. They regularly worked with multi-disciplinary teams to help protect vulnerable patients.

  • Arrangements had been made which helped meet the needs of patients who were also carers.

  • To promote better access for patients with disabilities, the practice had developed an electronic accessibility template, to help staff highlight this group of patients on the clinical system, so this could be taken into account when providing care and treatment.