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Inspection Summary


Overall summary & rating

Good

Updated 17 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Glebe Practice on 30 June 2015. The overall rating for the practice was requires improvement. The full comprehensive report on the June 2015 inspection can be found by selecting the ‘all reports’ link for The Glebe Practice on our website at www.cqc.org.uk.

This inspection was undertaken to review the progress made and was an announced comprehensive inspection on 10 January 2017. Overall the practice is now rated as good.

Our key findings were as follows:

  • There was an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.

  • Risks to patients were assessed and well managed.

  • The practice had signed up to the Dispensing Services Quality Scheme (DSQS), which rewards practices for providing high quality services to patients of their dispensary.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

  • Information for carers was available and the practice were reviewing the way carers were identified on the patient administrative system.

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • The practice had a vision and strategy to deliver high quality care and promote good outcomes for patients.

  • There was a governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

In addition the provider should:

  • Continue to identify, record and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 February 2017

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.
  • When things went wrong patients received support, an explanation and a written apology. They were also told about any actions to improve processes to prevent the same thing happening again.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed.
  • The practice had signed up to the Dispensing Services Quality Scheme (DSQS), which rewards practices for providing high quality services to patients of their dispensary.

Effective

Good

Updated 17 February 2017

The practice is rated as good for providing effective services.

  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.
  • Clinical audits were carried out and demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 17 February 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice higher than others for several 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 saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • Information for carers was available and the practice were reviewing the way carers were identified on the patient administrative system.

Responsive

Good

Updated 17 February 2017

The practice is rated as good for providing responsive services.

  • Practice staff 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.
  • Most patients said they found it easy to make an appointment and 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 the practice responded quickly to issues raised.

Well-led

Good

Updated 17 February 2017

The practice is rated as good for being well-led.

  • The practice had a vision and strategy to deliver high quality care and promote good outcomes for patients.
  • There was a clear leadership structure and staff felt supported by management.
  • There was a 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 sought feedback from staff and patients, which it acted on.
Checks on specific services

People with long term conditions

Good

Updated 17 February 2017

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

  • Nursing staff had lead roles in chronic disease management.
  • Patients at risk of hospital admission were identified as a priority and unplanned admissions were discussed regularly.
  • Performance for diabetes related indicators was comparable to CCG and national averages. (96% compared to 92% CCG average and 90% national average).
  • Longer appointments and home visits were available when needed.
  • All these patients had a named GP and were offered a structured annual review to check their health and medicines needs were being met.
  • For those patients 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 17 February 2017

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 comparable to national averages for all standard childhood immunisations.
  • The practice’s uptake for the cervical screening programme was 85%, which was comparable to the CCG average of 84% and the national average of 81%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies, including baby changing facilities.
  • We saw positive examples of joint working with midwives, health visitors and school nurses.
  • Health promotion boards displayed information relevant to this group in the patient waiting areas.

Older people

Good

Updated 17 February 2017

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.
  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
  • The practice offered a free home medication delivery service twice a week to older people who were unable to access the practice easily.
  • Outreach clinics in surrounding villages during the flu season were provided.

Working age people (including those recently retired and students)

Good

Updated 17 February 2017

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, including the ability to book appointments and request repeat prescriptions.
  • A full range of health promotion and screening was offered that reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 17 February 2017

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

  • Performance for mental health related indicators comparable to CCG and national averages. (100% compared with 92% CCG average and 93% national average).
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
  • The practice 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.
  • The practice 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 patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 17 February 2017

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 travellers and those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • The practice informed 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 and were aware of their responsibilities.