The Care Quality Commission
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Archived: St. Andrew's Medical Practice

Overall: Good read more about inspection ratings

St Andrews Lane, Spennymoor, County Durham, DL16 6QA (01388) 817777

Provided and run by:
St. Andrew's Medical Practice

All Inspections

11 January 2018

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 28 June 2016 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at St Andrew’s Medical Practice on 11 January 2018. We inspected this service as part of our comprehensive inspection programme.

At this inspection we found:

  • Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.
  • Outcomes for patients who use services were good.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The practice had recently reviewed the appointment system and were able to provide 13% more appointments than the year before. The skill mix of the clinical staff had been enhanced to free up GP time.
  • There was a leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
  • The practice was aware of and complied with the requirements of the duty of candour.
  • There was a focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

  • The practice ran a dedicated nurse led weekly drop in clinic for teenagers. This was funded by the practice and was also available to patients who were not registered with the practice. The service provided targeted support to teenagers including matters relating to sexual health and drug and alcohol abuse.

The areas where the provider must make improvements as they are in breach of regulations are; (See Requirement Notice Section at the end of this report for further detail).

  • Ensure care and treatment is provided in a safe way to patients

The areas where the provider should make improvements are:

  • Review Standard Operating Procedures to ensure they are fit for purpose and reflect current practices.
  • Review the management of controlled stationery having due regard to national guidance.
  • Carry out a risk assessment for staff who had not received a Disclosure and Barring Service (DBS) check.
  • Review the arrangements in place for infection control.
  • Introduce a system to ensure patient safety alerts have all been followed up and actioned where appropriate.
  • Assure themselves that patients know how they can complain to the Parliamentary Health Service Ombudsman (PHSO).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Andrew’s Medical Practice on 28 June 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 by staff who were experienced and well trained.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment in line with nationally accredited best practice.
  • 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 and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • There was a focus on continuity of care with named GPs for patients with specific needs and urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on. This included an active patient forum group that contributed to improvements in the practice.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice relating to the responsiveness of the practice to patient need:

  • A dedicated GP and nurse led a weekly drop-in service for teenagers. This was open to patients and those who were not registered with the practice but needed advice and support. This service provided targeted support to teenagers including with needs relating to sexual health and drug and alcohol use. Use of the drop-in service was well managed and staff liaised with community mental health and primary care services to ensure patients received the most appropriate support.

  • The practice demonstrated a high rate of success in its approach to health improvement strategies. This included a 65% success rate in smoking cessation and a 2.6% reduction in teenage pregnancies.

  • Special services were available for patients who self-harmed, or who were at risk of doing so. This included the availability of ad-hoc appointments with no notice, referrals to community psychiatric liaison teams and in-house counselling.

  • The practice worked with a wellbeing health advisor who support patients with a learning disability, or other circumstances that meant they were vulnerable, to access health improvement services such as slimming or exercise groups or social support organisations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

4 November 2013

During a routine inspection

We spoke with six patients who attended the surgery on the day of our inspection.

The patients we spoke with were, without exception, satisfied that staff listened to their views and showed them respect. One patient said 'The doctor spent time talking to me and reassured me.' Another patient said 'The staff were really helpful and understanding.'

Without exception, the patients were very happy with the standard of care they received at the practice. Comments included 'I am confident I am looked after well' and 'The care is wonderful.'

Most of the patients we spoke with expressed a degree of dissatisfaction with the appointment booking system.

We saw medications were stored in locked cabinets within a locked room. We found all medicines were in date. We also saw prescription pads were held securely with access restricted to named staff members.

We found staff received regular training and supervision. Staff told us they felt supported by their managers.

We found the provider had a policy on obtaining feedback from patients. This included information from sources such as the Patient Forum Group, complaints and survey questionnaires.