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Inspection Summary


Overall summary & rating

Good

Updated 29 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr S R Gibbins and Partners on 20 April 2015. Overall the practice is rated as good.

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

Our key findings were as follows:

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

  • 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.

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

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

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG).

There were areas of practice where the provider should make improvements:

  • Expand the availability of emergency medicines to ensure that they are age appropriate.

  • Introduce a method of recording cleaning activities undertaken to evidence they have taken place.

  • Provide staff with regular appraisals and support personal development plans or record the reasons they cannot be met.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 29 October 2015

The practice is rated as good for safe. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Risks to patients were discussed and when necessary changes had been made to limit the risk. We saw that risks to patients, staff and visitors from the premises or environmental events were clearly recorded. Practice staff had been trained to deal with emergency events and equipment to help in an emergency was regularly checked and suitable for use.

Effective

Good

Updated 29 October 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were at or above average for the locality. Staff referred to guidance from National Institute for Health and Care Excellence (NICE) and used it routinely. Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training appropriate to their roles and any further training needs had been identified and appropriate training planned to meet these needs. There was evidence of appraisals and personal development plans for all staff, although the frequency of these was not always consistent. Staff worked with multidisciplinary teams.

Caring

Good

Updated 29 October 2015

The practice is rated as good for providing caring services. Data showed that patients rated the practice in line with 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 to help patients understand the services available was easy to understand. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

The evidence from the GP national patient survey published in January 2015 showed patients were satisfied with how they were treated and that this was with compassion, dignity and respect. For example,

  • 86% described their overall experience of the GP practice as at least fairly good. This was the same as the clinical commissioning group (CCG) average.
  • 83% said the GP was good at treating them with care or concern. This was the similar to the CCG average of 85%.
  • 98% felt that the nurse had treated them with care and concern. This was higher than the CCG average of 90%.

Responsive

Good

Updated 29 October 2015

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 (CCG) to secure improvements to services where these were identified.

The practice worked with their patient participation group (PPG) including conducting regular in-house patient satisfaction surveys to make improvements to services. 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.

Well-led

Good

Updated 29 October 2015

The practice is rated as good for being well-led. Staff told us their aim was to improve the health of patients and provide high quality care.

There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity. There were systems in place to monitor and improve quality and identify most risks. The practice proactively sought feedback from staff and patients.

Checks on specific services

People with long term conditions

Good

Updated 29 October 2015

The practice is rated as good for the care of people with long-term conditions. The nursing team had a lead role in chronic disease management and patients at risk of hospital admission were identified as a priority. 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 medication 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.

Nationally reported data from 2013/14 showed that outcomes for patients with long-term conditions were good. For example, 89% of patients with chronic obstructive pulmonary disease (COPD) had been reviewed in the last year. This was higher than the CCG average of 77% and national average of 80%. Practice supplied data showed that the 2014/15 performance had increased to 91%.

Families, children and young people

Good

Updated 29 October 2015

The practice is rated as good for the care of families, children and young people. There was a formal system in place to identify and follow up children living in disadvantaged circumstances and who were at risk. Immunisation rates were in line with the local average 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

Older people

Good

Updated 29 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. For example, in dementia and avoiding unplanned hospital admissions. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All patients over the age of 75 had a named GP.

Working age people (including those recently retired and students)

Good

Updated 29 October 2015

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 reflected the needs of this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 29 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety four per cent of patients on the practice register for dementia had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia. 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 (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 29 October 2015

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 those with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. 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.