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Inspection Summary


Overall summary & rating

Good

Updated 6 April 2016

Letter from the Chief Inspector of General Practice

In May 2015 during a comprehensive inspection of Loddon Vale Practice, Hurricane Way, Woodley, Reading, Berkshire we found concerns related to the following: The recruitment of staff, management of medicines, systems to monitor risk, clinical audit, assessment of mental capacity, safeguarding and vetting of staff undertaking chaperone duties. The report setting out the findings of the inspection was published in September 2015. Following the inspection the practice sent us an action plan detailing how they would improve on the areas of concern.

We carried out an announced focused inspection of Loddon Vale Practice on 23 February 2016 to ensure the changes the practice told us they would make had been implemented and to apply an updated rating.

We found the practice had made significant improvements since our last inspection on 27 May 2015. We have re-rated the practice overall as good. Specifically, they had made improvements to the provision of safe, effective and well led services. The ratings for the practice have been updated to reflect our findings.

At this inspection we found:

  • Risks to patients were assessed and well managed.
  • Systems were in place to respond to national safety alerts.
  • Staff had been trained to identify possible abuse and to report any concerns in this respect appropriately.
  • Appropriate checks had been undertaken for staff who undertook chaperone duties.
  • Care planning had been improved to involve the patient in their future care.
  • Systems to manage medicines had been improved.
  • The practice had enhanced their programme of clinical audit and audit was driving improvement in patient outcomes.

However,

  • The practice had not improved on the number of patients with a learning disability who had received their annual health check in 2015.

The area where the provider should make improvement is:

  • To ensure that all patients with a learning disability are offered an annual health check in 2016. Promote the benefits of such checks to this group of patients and their carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 6 April 2016

The practice is rated good for provision of safe services. They had made significant improvements since our last visit in May 2015.

Specifically the practice:

  • Operated a system for monitoring and taking action when in receipt of national safety alerts.

  • Completed appropriate checks for staff who undertook chaperone duties.

  • Managed medicines in accordance with legislation.

  • Followed appropriate processes when recruiting staff.

  • Had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

  • Had systems in place to ensure risks to patients were assessed and well managed.

Effective

Good

Updated 6 April 2016

The practice is rated good for provision of effective services.They had made significant improvements since our last visit in May 2015.

Specifically the practice:

  • Carried out a programme of clinical audits to demonstrate quality improvement.

  • Completed care planning in conjunction with the patients and recorded the patient’s consent to their care plan.

  • Ensured staff were trained appropriately to carry out assessments of patient’s capacity to consent to treatment.

However, the practice should address

  • Increasing the number of patients with a learning disability who receive and annual health check.

Caring

Good

Updated 3 September 2015

The practice is rated as good for providing caring services. Data showed that patients rated the practice similarly to 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. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

Responsive

Good

Updated 3 September 2015

The practice is rated as good for providing responsive services. It engaged with the NHS England Area Team and Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. Patients were becoming positive about the ease of making an appointment and reported good access to urgent appointments. The practice was responsive to patient feedback on access to services and was continuing to make improvements. A new telephone system was to be installed the week after inspection. The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand and evidence showed that the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 6 April 2016

The practice is rated good for provision of well led services. They had made significant improvements since our last visit in May 2015.

Specifically the practice had:

  • Improved the identification, assessment and management of risk.

  • Enhanced the training and development for staff across all disciplines.

  • Clarified their governance framework to support the delivery of good quality care.

Checks on specific services

People with long term conditions

Good

Updated 6 April 2016

The practice is rated as good for the care of patients with long term conditions having addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice had implemented;

  • A robust system to identify, assess and act on environmental risk for all patient groups.

  • Face to face care planning for patients with long term conditions who were at a higher risk of hospital admission

    .

  • Procedures to ensure medicine alerts were responded to and action taken recorded.

Families, children and young people

Good

Updated 6 April 2016

The practice is rated as good for the care of families, children and young patients having addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice ensured:

  • Staff were trained in and understood the process to assess the capacity of young patients to consent to treatment.

  • Staff had received relevant training in safeguarding children and were able to demonstrate their understanding of identification of possible abuse and how to report concerns.

  • Systems to identify, assess and act on environmental risk for all patient groups were in place.

Older people

Good

Updated 6 April 2016

The practice is rated as good for the care of older patients having addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice had implemented a system to;

  • Identify, assess and act on environmental risk for all patient groups.

  • Involve older patients at risk of hospital admission in planning their care particularly in relation to avoiding hospital admission.

  • Ensure care plans were detailed and shared with other relevant care providers.

  • Advise older patients of the support available from both voluntary and statutory agencies during the care planning process.

Working age people (including those recently retired and students)

Good

Updated 6 April 2016

The practice is rated as good for the care of working age patients (including those recently retired and students). They had addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice had;

  • Systems in place to identify, assess and act on environmental risk for all patient groups.

  • Ensured travel vaccines were delivered in accordance with legislation.

People experiencing poor mental health (including people with dementia)

Good

Updated 6 April 2016

The practice is rated as good for the care of patients experiencing poor mental health including those living with dementia. They had addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice had;

  • Ensured staff were appropriately trained to carry out assessment of a patient’s capacity to consent to treatment.

  • Implemented face to face care planning which would include patients identified with long term mental health problems and those living with dementia.

  • Systems in place to identify, assess and act on environmental risk for all patient groups.

People whose circumstances may make them vulnerable

Good

Updated 6 April 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable. They had addressed previous breaches of regulations relating to safe, effective and well led delivery of care and treatment.

Specifically the practice had ensured;

  • Staff knew how to recognise signs of abuse in vulnerable adults. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

  • Systems to identify, assess and act on environmental risk for all patient groups were in place.

  • All staff undertaking chaperone duties had undergone a DBS check.

However,

  • Undertaking annual health checks for patients with a learning disability remained at 33% and this should be improved.