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Inspection carried out on 29 Jan 2020

During an inspection to make sure that the improvements required had been made

We carried out an announced focused inspection at Woodlea House Surgery on 29 January 2020 as part of our inspection programme.

We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection focused on the following key questions:

Is the service effective?

Is the service well led?

Because of the assurance received from our review of information we carried forward the ratings for the following key questions:

Is the service safe?

Is the service caring?

Is the service responsive?

The practice was previously inspected in September 2016 and the report published in November 2016 with an overall rating of Good and Good in each key question and population group.

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 for providing services because:

  • The practice organised and delivered services to meet patients’ needs.
  • The number of complete cycle clinical audits processes was relatively low at the time of inspection.
  • GPs met daily to complete administration, telephone calls and for peer review and communication. Locum GPs were provided with information packs.
  • The practice was engaging well with other stakeholders and was in the process of merging with the south coast medical group.
  • All staff we spoke with felt supported by the leadership team. The practice had shown great resilience in overcoming significant staffing changes in 2019.
  • Patient feedback from a wide range of sources was very positive about the practice.
  • The practice actively identified carers and had successfully identified 3% of their practice population, in order to provide them with appropriate support.
  • The practice was dementia friendly and staff had received training in this area.
  • The practice actively identified military veterans and had an armed forces covenant policy in order to ensure veterans received priority access to secondary care for any conditions relating to service to their country.

We rated the four population groups of older people, working age people, vulnerable people, families, children and young people, patients experiencing mental health issues including dementia as good.

We rated the population group of patients with long term conditions as requires improvement. This was because of higher than average exception reporting for patients with long term conditions. The practice acknowledged that it was in the process of improving its rates of exception reporting in the quality outcomes framework (QOF) for patients in this population group.

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

  • Continue to review and improve its exception reporting for patients with long term conditions such as diabetes, asthma, COPD and hypertension.
  • Continue to review and improve cervical cancer screening in line with national guidance.

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

Inspection carried out on 27 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodlea House practice on Tuesday 27 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected 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.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • The practice was involved in the Unplanned Admissions scheme and a clinical commissioning group (CCG) locality project for the care of the over 75’s.

  • GPs provided a primary medical service to a local care home and had 13 permanently registered patients living there. GPs offered a weekly ward round and also visited on other days if required. The home had a quick access telephone number.

  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice proactively identified carers within the practice patient list and worked closely with the voluntary services coordinator to signpost patients to services which included coffee mornings, counselling services, support groups and befriending organisations.

  • Practice staff passed on information about voluntary services as much as possible to try and get support for those who would benefit from it. For example, the Cinnamon Trust who arranged care for dogs when people have to be admitted to hospital or who become too frail to care for their dog, and ‘The Silver Line’, a 24 hour call line for elderly people to call if they are lonely.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

  • 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.
  • The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • All aspects of administration within the organisation were clearly followed, detailed, structured and kept under review.

  • The leadership was non-hierarchical and supportive and was used to drive and improve the delivery of high quality person-centred care.

We saw two areas of outstanding practice:

  • There was a practice led weekly ‘cancer care’ meeting where patients with a newly diagnosis of cancer or vulnerable patients with cancer were discussed to ensure they were receiving appropriate support and treatment. The meetings had resulted in increased social care input and interventions which benefitted patients.

  • The practice had identified 170 patients as carers (4.3% of the practice list).This was an increase of 89 patients since April 2015. The practice had set themselves a target to reach 5% at the end of the year and had a plan in place to achieve this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice