The Staunton Surgery

We carried out an announced comprehensive inspection at The Staunton Surgery on 4 December 2018 as part of our inspection programme and found breaches of regulations and the practice was rated as requires improvement. This inspection on 5 December 2019 was an announced comprehensive inspection to follow up on breaches of regulation and as part of our inspection schedule where services rated as requires improvement are subject to re-inspection within 12 months.

This inspection looked at the following key questions:

• Safe
• Effective
• Caring
• Responsive
• Well-led

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 overall and good for the population groups with the exception of people experiencing poor mental health which is rated as requires improvement due to high QOF exception reporting.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff had received training appropriate to their role.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• There was a clear leadership structure and staff felt supported by management.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

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

• Continue to review and improve the uptake of cervical screening and the childhood immunisation programme.
• Continue to review and improve the reduction in exception reporting for patients with long term conditions and poor mental health.
• Review and improve cancer detection rates.

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

This practice is rated as Requires Improvement overall. (Previous rating July 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at The Staunton Surgery on 4 December 2018 as part of our inspection programme.

At this inspection we found:

• The practice had undergone a significant change in practice leadership following the sudden retirement of their previous senior GP and loss of other GP partners. The practice had been saved from potential closure by the introduction of new GP partners.
• The practice remained without a confirmed registered manager despite notification letters from the Care Quality Commission having been sent to the practice in June 2018.
• The practice had overcome the loss of approximately 50% of its staff by recruiting more clinical and administrative staff, to maintain its patient care to a high standard.
• The practice had made changes to its reception and patient waiting area to improve patient confidentiality and protect staff duties.
• 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.
• The practice did not have an active patient participation group but patient feedback was actively sought through surveys and Friends and Family Test questionnaires.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvement are:

• Ensure all regulated activities are managed by an individual who is registered as a manager.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

The areas where the provider should make improvements are:

• Continue to improve the uptake for cervical screening to achieve the national target of 80%.
• Continue to improve arrangements for an active patient participation group.
• Continue to improve the uptake for childhood immunisations to achieve the national target of 90% or above in all four indicators.
• Continue to review exception reporting to be in line with local and national averages.
• Continue to review patient feedback regarding their experiences of accessing the practice via telephone or waiting times once at the practice.

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

Please refer to the detailed report and the evidence tables for further information.