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Inspection Summary


Overall summary & rating

Good

Updated 25 July 2019

We carried out an announced focused inspection at Cowplain Family Practice on 18 June 2019 as part of our inspection programme. This inspection was to look at the breaches to regulations identified from our previous inspection in March 2018 when the practice was rated as good overall but requires improvement in the key question of Safe. This inspection was a follow up on the Safe key question only. Prior to the inspection we undertook an annual regulatory review which indicated no other key questions needed to be inspected.

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 have rated this practice as good for Safe.

We found that:

  • The practice had made improvements to systems and processes to keep patients safe, particularly in the areas identified as requiring improvement at our previous inspection.
  • All staff had now received training suitable to their role specifically in safeguarding children and vulnerable adults.
  • The practice had identified a new lead for oversight of infection prevention and control and had made improvements to the areas raised in the previous report.
  • The practice was recording water temperatures in line with national health and safety guidance, but the practice could not demonstrate how it was responding to temperatures that were out of range.
  • The practice did not have appropriate security measures in place for its prescription stationery.
  • All staff had received fire safety training, but the practice had not identified designated fire marshals.
  • We found the patient group directives had been signed and authorised but there was evidence in a delay in this process from the date of validation to date of authorisation.

Whilst we found no breaches of regulations, the provider should:

  • Consider reviewing policies to include reference to patients using online services.
  • Review the process of authorising patient group directives in a timely manner.
  • Review the process for the management of controlled stationery such as blank prescriptions in line with national guidance.

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

Inspection areas

Effective

Good

Updated 15 May 2018

Caring

Good

Updated 15 May 2018

Responsive

Good

Updated 15 May 2018

Well-led

Good

Updated 15 May 2018

Checks on specific services

People with long term conditions

Good

Updated 22 October 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. 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 medication needs were being met. For those people 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 22 October 2015

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 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. 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

Good

Updated 22 October 2015

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.

Working age people (including those recently retired and students)

Good

Updated 22 October 2015

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)

Good

Updated 22 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Practice records showed that 69 out of 72 patients on their register had received a health check and 24 out of 26 patients with a mental health diagnosis had an agreed care plan in place. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice hosted a monthly memory clinic run by a specialist nurse and had a dementia drop in service.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 22 October 2015

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. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

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