The Care Quality Commission
  • Doctor
  • GP practice

Archived: Merchiston Surgery

Overall: Good read more about inspection ratings

Highworth Road, Stratton St Margaret, Swindon, Wiltshire, SN3 4BF (01793) 823307

Provided and run by:
Merchiston Surgery

Important: The provider of this service changed. See new profile

All Inspections

1 May to 1 May 2018

During a routine inspection

This practice is rated as Good overall. (Previous inspection 16 September 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Merchiston Surgery on 1 May 2018 as part of our inspection programme.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.
  • Patients could access a community navigator, employed by Swindon Borough Council. The community navigator supported patients to become more independent and use community services to prevent isolation and mental health issues.
  • There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality. Merchiston Surgery identified patients at risk of developing diabetes who were not on the diabetes register, and implemented changes that could help to prevent the progression of this health condition.
  • The practice hosted a talking therapy service for patients who had experienced bereavement, were carers, or were experiencing mental health issues.
  • The practice hosted screening services for abdominal aortic aneurysms and breast abnormalities.
  • Twenty-two per-cent of patients aged 75 years and over were registered for online services.

The areas where the provider should make improvements are:

The provider should continue to make efforts to lower its exception reporting rates for Quality and Outcomes Framework (QOF) indicators.

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

16th September 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focussed inspection of Merchiston Surgery Stratton St Margaret, Swindon, Wiltshire, SN3 4BF on 16 September 2015.

Our previous inspection on 21 October 2014 found breaches of regulations relating to the safe delivery of services. We found the practice required improvement for the provision of safe services and was rated good for providing effective, caring, responsive and well led services. Overall the practice was rated as good.

This inspection was undertaken to check the practice was meeting regulations. For this reason we have only rated the practice for the key question relating to safety.

We found the practice was meeting the regulations that had previously been breached in relation to medicines management and recruiting staff safely.

We found that the practice had made other improvement in the way it processed pathology results and storage of emergency medicines and equipment.

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

  • There was an updated medicines management policy to ensure there were safe medicine management systems. This policy reflected the current practice in place and included appropriate vaccine protocols.
  • Medicines were held securely.
  • The recruitment policy had been updated to reflect current legislation and recruitment procedures for each staffing group.
  • Criminal background checks had been carried out through the Disclosure and Barring Service for those staff that required them.
  • There was a clear system for the processing of pathology results and checks. These were undertaken twice daily to ensure that patients’ abnormal results were responded to quickly.
  • Emergency medicines and equipment was stored centrally and was easily accessible to staff.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

21 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection visit to Merchiston Surgery on 21 October 2014.

During the inspection we gathered information from a variety of sources. For example, we spoke with patients, members of the patient participation group, interviewed staff of all levels and checked the systems and processes in place.

Overall the practice is one which is rated as good. This is because we found Merchiston Surgery provided the care and treatment patients required in order to meet their needs. We found patients using this service experienced good effective, responsive and caring outcomes. However, we found that services provided were not safe in respect of medicines management.

Our key findings were as follows:

  • On the whole patients’ safety and welfare was protected.
  • Patients in the population groups of older people and those with long term health needs were supported well and there were systems in place to ensure their needs would be met.
  • Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions
  • Patients were able to have appointments with a GP of their choice and continuity of care, with urgent appointments available the same day.
  • Merchiston Surgery participated in pilot schemes which promoted self-care and good health.
  • There was a clear leadership structure and staff felt supported by management to deliver care

However, there were also areas of practice where the provider needs to make improvements. The provider must:

  • Review the medicines management policy and procedure and ensure that there are safe systems in place. There were risks as medicines were not being stored securely as access to where these were stored was available to all staff working in the building. Medicine fridges were left unlocked.
  • Ensure there is a written policy and procedure for the system of receiving and checking vaccines

when they were delivered and therefore ensuring the cold chain was maintained.

In addition the provider should:

  • There should be a system for monitoring blood and other pathology results at the practice so that any patients’ abnormal results were responded to quickly.
  • Emergency equipment and medicines are required to be stored in a central area and easily accessible.
  • The practice should have a written protocol for receiving, handling and storing specimens. Checks should be made on temperatures of the specimen fridge to ensure the correct temperature was maintained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice