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Archived: Green Wrythe Surgery Good

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Reports


Inspection carried out on 26 April 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Green Wrythe Surgery on 8 January 2015. The overall rating for the practice was requires improvement. The full comprehensive report on the January 2015 inspection can be found by selecting the ‘all reports’ link for Green Wrythe Surgery on our website at www.cqc.org.uk.

This announced comprehensive inspection was undertaken on 26 April 2017. The provider had made improvements in all the areas where issues were identified in the inspection in January 2015. Overall the practice is now rated as good.

Our key findings 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 including appropriate recruitment checks for staff.
  • 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. We reviewed a sample of patient records and found that the care was delivered in line with current evidence based guidance.
  • 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.
  • Seven out of eight patients we spoke to said they found it was difficult to get an emergency appointment and said they had to wait approximately a week to get an appointment with a named GP. However, we found that emergency appointments were available on the day of inspection.
  • 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, however the Patient Participation Group felt that some of the suggestions they made were not acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

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

The provider should:

  • Review practice systems to ensure there is a clear system in place to monitor the implementation of medicines and safety alerts.
  • Ensure there are failsafe systems in place to monitor refrigerators where medicines are stored.
  • Ensure the business continuity plan is up to date.
  • Review how patients with caring responsibilities are identified to ensure information, advice and support can be made available to them.
  • Review practice procedures to ensure all patients with a learning disability have regular health checks.
  • Review the national GP patient survey results and address low scoring areas to improve patient satisfaction.
  • Review practice procedures to ensure all policies and procedures were reviewed appropriately to ensure they are up to date.
  • Consider documenting discussions from practice nurse meetings.
  • Review practice procedures to ensure that the suggestions made by the PPG were acted on appropriately.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 8 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Green Wrythe Surgery on 8 January 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to require improvement for providing safe and effective services. It also required improvement for providing services to people with long term conditions, families, children and young people, People whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). The practice we found was good for providing caring, responsive and well-led services. It was also good for providing services to older people and working age people (including those recently retired and students).

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

  • Risks to patients were assessed and well managed, with the exception of those relating to long term conditions and health checks.
  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks and safeguarding.
  • Patients said they were mostly 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 at request and easy to understand.
  • Urgent appointments were usually available on the day they were requested.

The areas where the provider must make improvements are:

  • Ensure all necessary criminal record recruitment checks for all staff providing chaperone duties.
  • Ensure all practice staff have access to appropriate and up to date policies, procedures and guidance to carry out their role.
  • Ensure staff recruitment files and records are in line with the required standards and checking requirements.
  • Ensure all practice staff are trained in safeguarding.
  • Ensure patients’ records are in line with best practice guidelines, and that management of conditions are reviewed and acted on appropriately and in a timely manner.

In addition the provider should:

  • Improve staff understanding of issues relating to consent to treatment.
  • Ensure all staff receives a regular performance review and an annual appraisal.
  • Provide information on flu vaccine targets and uptake as the practice level was lower than the national average.
  • Improve communication with patients by having a comments and suggestions box.
  • Improve access to the practice complaints form which was not readily available within the waiting area, and had to be requested from reception staff. Likewise for the practice leaflet.
  • The practice did not have a practice wide vision and statement, leadership, shared working and responsibility that are clear, documented and all staff are signed up to and encouraged to be part off.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice