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Inspection Summary


Overall summary & rating

Good

Updated 14 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mill Street Medical Centre on 14 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • The practice is situated in extended purpose built premises. The practice was clean and had good facilities including disabled access and access to translation services.

  • The practice had recently merged with another smaller practice and provided services for 12,360 patients. The aims of the merger were to give patients a wider choice of clinicians, enhanced surgery opening times and more services.

  • The merger had come at a time when three GPs were on maternity leave and the practice had struggled to recruit GPs to cover. During this period, the practice had prioritised the appointments to acutely unwell patients, the elderly and children. The practice had revised the appointment system, employed a new salaried GP and was employing a clinical pharmacist to reduce the pressure on the appointment system.
  • There were systems in place to mitigate safety risks including analysing significant events and safeguarding.
  • The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

  • Patients’ needs were assessed and care was planned and delivered in line with current legislation.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service; including having a patient participation group (PPG) and acted, where possible, on feedback.
  • Staff worked well together as a team and all felt supported to carry out their roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 October 2016

The practice is rated as good for providing safe services. The practice took the opportunity to learn from internal incidents and safety alerts, to support improvement. There were systems, processes and practices in place that were essential to keep patients safe including medicines management and safeguarding.

Effective

Good

Updated 14 October 2016

The practice is rated as good for providing effective services. Patients’ needs were assessed and care was planned and delivered in line with current legislation. Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average. Clinical audits demonstrated quality improvement. Staff worked with other health care teams. Staff received training suitable for their role.

Caring

Good

Updated 14 October 2016

The practice is rated as good for providing caring services. Patients’ views gathered at inspection demonstrated they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We also saw that staff treated patients with kindness and respect.

Responsive

Good

Updated 14 October 2016

The practice is rated as good for providing responsive services. 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.

Well-led

Good

Updated 14 October 2016

The practice is rated as good for being well-led. There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity. The practice proactively sought feedback from staff and patients and had an active PPG. Staff had received inductions and attended staff meetings and events.

Checks on specific services

People with long term conditions

Good

Updated 14 October 2016

The practice is rated as good for providing services for people with long term conditions.  The practice had registers in place for several long term conditions including diabetes and asthma. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 14 October 2016

The practice is rated as good for providing services for families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

Older people

Good

Updated 14 October 2016

The practice is rated as good for providing services for older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and care home visits. The practice participated in meetings with other healthcare professionals to discuss any concerns. There was a named GP for the over 75s.  The practice was involved in a project looking at identifying those elderly patients, particularly those with dementia, or who were taking several medications, which were at increased risk of falls injuries and proactively referring these patients to the local falls assessment team.

Working age people (including those recently retired and students)

Good

Updated 14 October 2016

The practice is as rated good for providing services for working age people. The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. There were online systems available to allow patients to make appointments. The practice offered extended opening hours on Tuesday evenings until 8.45pm and early Thursday morning appointments from 7am.

People experiencing poor mental health (including people with dementia)

Good

Updated 14 October 2016

The practice is rated as good for providing services for people experiencing poor mental health. Patients experiencing poor mental health received an invitation for an annual physical health check. Those that did not attend had alerts placed on their records so they could be reviewed opportunistically.  The practice worked with a mental health nurse.

People whose circumstances may make them vulnerable

Good

Updated 14 October 2016

The practice is rated as good for providing services for people whose circumstances make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. The practice also had a substance misuse clinic.