During an assessment under our new approach
Date of Assessment: 2/10/2025 to 8/10/2025. The assessment was due to the length of time since we last assessed the service. The last assessment was carried out in September 2016 and the practice was rated Good overall. Streatfield Surgery is a GP practice and delivers service to 7868 under a contract held with NHS England. The National General Practice Profiles states that the ethnicity of the practice population is 55.80% Asian, 30.88% White, 2.42% Mixed, 5.36% Black and 5.55% Other. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 8th decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. However, we found room for improvement during our clinical searches. We found lack of a consistent follow up for patients who suffered an acute asthma attack; patients prescribed medicines without the appropriate monitoring and no record of some patients on a medicine to treat depression being made aware of the associated risks.
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. When people were assessed as not having capacity to make a decision, the service involved relevant parties to support in decision making on behalf of the person.
People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and treatment. The service supported staff wellbeing.
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
Leaders and staff had a shared vision and culture based on caring, quality, respect, access and working together. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.
However, we did find some areas for improvement in relation to governance. For example, during our on-site visit, we found gaps in training files. There was a shortfall with the oversight of staff recruitment records. The service took action after our visit to put this right and we saw evidence that staff were now all up to date with their required training. Our clinical searches showed that medication reviews were not always detailed. There was not an appropriate system in place to identify if the information in medication reviews were sufficient.
We found breaches of regulation in relation to Regulation 17 – Good governance and Regulation 12 – Safe care and treatment. We have asked the provider for an action plan in response to the concerns found at this assessment.