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Inspection Summary


Overall summary & rating

Good

Updated 13 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Auckland Surgery on 5 October 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for Auckland Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

  • The practice had taken action to address on all of the issues identified at the previous inspection.
  • There were effective systems in place for acting on patient safety alerts, monitoring prescription forms, ensuring emergency medicines availability on home visits, and monitoring uncollected test request forms and prescriptions.
  • Patient group directions were in place to allow a nurse to administer medicines in line with legislation.
  • There was support and oversight of all clinicians, including the independent nurse prescribers.
  • There was a system to ensure all staff received an annual appraisal.
  • The practice were taking active steps to monitor and improve its identification and recording of patients with long-term conditions, including Coronary Heart Disease, and to improve the identification of patients with learning disabilities and the support provided to them.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 13 June 2017

The practice is now rated as good for providing safe services.

  • There were effective systems in place for acting on patient safety alerts, monitoring prescription forms, ensuring emergency medicines availability on home visits, and monitoring uncollected test request forms and prescriptions.
  • Patient group directions were in place to allow a nurse to administer medicines in line with legislation.
  • There was support and oversight of all clinicians, including the independent nurse prescribers.

Effective

Good

Updated 6 January 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.
  • There were two indicators for which the practice was an outlier for the period 2014 – 15, both measures of the practice’s identification and recording of patients with long-term conditions. We saw evidence that the practice had taken action to improve their performance in this area.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Annual appraisals had not been happening consistently. The practice had employed an assistant practice manager and developed a new GP timetable to allow more resource for such activities, and the outstanding appraisals had been scheduled.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 6 January 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.
  • Patients at the practice had priority to see the visiting cognitive behavioural therapy (CBT) therapist. GPs also directed patients to the online 'mood gym' CBT modules. One of the GPs also provided seven hours of therapy per week.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 6 January 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.
  • Patients said they found it easy to make an appointment with a named GP 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.
  • We heard examples of practice staff providing extra support for patients; when following up test results, supporting changes in accommodation or care arrangements or by proving cups of tea in reception or help with taxis.
  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 13 June 2017

The practice is now rated as good for providing well-led services.

  • The practice had taken action to address all of the governance issues identified at the previous inspection.
  • There was a system to ensure all staff received an annual appraisal.
Checks on specific services

Older people

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People with long term conditions

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Families, children and young people

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Working age people (including those recently retired and students)

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People whose circumstances may make them vulnerable

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People experiencing poor mental health (including people with dementia)

Good

Updated 13 June 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 5 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.