You are here

Inspection Summary


Overall summary & rating

Good

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Towcester Medical Centre on 9 December 2015. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • 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.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 18 February 2016

The practice is rated as good for providing safe services. They had an effective system in place for reporting and recording significant events and demonstrated that they ensured lessons were shared and actions were taken to improve safety in the practice.  They had an open and honest approach to when things went wrong and carried out investigations appropriately, shared outcomes and apologised to patients when necessary. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse and included having individuals responsible for specific areas of the practice.  Risks to patients were assessed and well managed and regularly reviewed.

Effective

Good

Updated 18 February 2016

The practice is rated as good for providing effective services. Data showed patient outcomes were at or above average for the locality.  The practice carried out regular clinical audits which demonstrated quality improvement.  Staff had the skills, knowledge and experience to deliver effective care and treatment in line with current evidence based guidance.  There was evidence of appraisals and personal development plans for all staff and training for staff was monitored and well co-ordinated. Staff worked with multidisciplinary teams and the local community to understand and meet the needs of the practice population, including schools and care homes.

Caring

Good

Updated 18 February 2016

The practice is rated as good for providing caring services. Data showed that patients rated the practice higher than others for all 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 observed that staff treated patients with kindness and respect, and maintained confidentiality and the practice demonstrated a commitment to and understanding of the issues affecting patients in the community.

Responsive

Good

Updated 18 February 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. For example, the practice hosted the INR clinic for patients in the area and they also had GPs with special interests and were looking to develop cardiology services closer to home. (The INR is a clinic for patients who require lifelong monitoring of bloods for anticoagulation therapy)

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.

Well-led

Good

Updated 18 February 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 practice was aware of and complied with the requirements of the Duty of Candour and the partners encouraged a culture of openness and honesty. They had systems in place for ensuring awareness of all safety incidents occurring in the practice and robust systems for managing all risks.

The practice proactively sought feedback from staff and patients, which it acted on and the patient participation group was active and valued.  There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions

Good

Updated 18 February 2016

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.

  • Staff were trained in various long term conditions and the practice achieved good outcomes for patients in this group.

  • 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 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 18 February 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 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. Postnatal checks were offered for new mothers and the practice offered a cervical screening programme in line with national guidance.

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

Older people

Good

Updated 18 February 2016

The practice is rated as good for the care of older people.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.

  • It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Longer appointments and home visits were available for older people when needed, and this was acknowledged positively in feedback from patients.

Working age people (including those recently retired and students)

Good

Updated 18 February 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. The practice also used social media such as Twitter and Facebook to advertise health promotion messages.

People experiencing poor mental health (including people with dementia)

Good

Updated 18 February 2016

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

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

  • The practice carried out annual mental health reviews and referred to the wellbeing teams and community mental health team when required.

  • 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.

  • It had 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 people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 18 February 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 people, travellers and those with a learning disability.

  • It offered longer appointments for people with a learning disability and engaged with the special educational needs co-ordinator at the local school.

  • 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.

  • They had a triage service for patients requiring immediate help.