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Inspection Summary


Overall summary & rating

Good

Updated 17 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced focussed follow up inspection on 24 January 2017 to follow up on concerns we found at Abbey Medical Practice in May 2016. The inspection in January 2017 was to ensure that improvement had been made following our inspection in May 2016 when breaches of regulations had been identified. The inspection in May 2016 found breaches of regulation and rated the practice as requires improvement in safe services.

At the inspection on 24 January 2017 we found that overall the practice had implemented changes and that the service was meeting the requirements of the regulations. The ratings for the practice have been updated to reflect our findings following the improvements made since our last inspection in May 2016; the practice is now rated as good in providing safe services.

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

  • Processes for reporting, recording, acting on and monitoring significant events, incidents and near misses including non-clinical were effective and implemented for all staff to follow.
  • Emergency equipment and medicines were monitored and expiry dates were checked.
  • A system for the flagging up of alerts for safeguarding vulnerable adults and children had been implemented and meetings were regular to ensure that outstanding safeguarding concerns had been followed up effectively.
  • There was a robust system in place to ensure that patients were safeguarded from abuse and improper treatment, including documented discussions with the health visitors regarding children at risk.

  • The practice had an effective system for monitoring high risk drugs with fail safes built in.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 February 2017

The practice is now rated as good for providing safe services.

Our last inspection in May 2016 identified concerns relating to safeguarding, reporting and recording of incidents, managing high risk medicines and emergency medicines.

At this inspection we saw the concerns had been addressed:

  • Processes for reporting, recording, acting on and monitoring significant events, incidents and near misses including non-clinical were effective and implemented for all staff to follow.
  • Emergency equipment and medicines were monitored and expiry dates were checked.
  • A system for the flagging up of alerts for safeguarding vulnerable adults and children had been implemented and meetings were regular to ensure that outstanding safeguarding concerns had been followed up effectively.
  • There was a robust system in place to ensure that patients were safeguarded from abuse and improper treatment, including documented discussions with the health visitors regarding children at risk.

  • The practice had an effective system for monitoring high risk drugs with failsafe’s built in.

Effective

Good

Updated 17 February 2017

Caring

Good

Updated 17 February 2017

Responsive

Good

Updated 17 February 2017

Well-led

Good

Updated 17 February 2017

Checks on specific services

People with long term conditions

Good

Updated 26 July 2016

The practice is rated as good for the care of people with long-term conditions.

  • Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

  • Performance for diabetes related indicators showed the practice had achieved 94% of targets which was higher than the CCG average (91%) and the national average (89%). For example, 99% of patients with diabetes, on the register, have had an influenza immunisation in the preceding 12 months. This was higher than the CCG average (96%) and national average (94%).

  • Longer appointments and home visits were available when needed.

  • All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

  • For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 26 July 2016

The practice is rated good for the care of 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.

  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

  • The practice’s uptake for the cervical screening programme was 87% which was higher than the CCG average of 85% and the national average of 82%.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • There was a children’s area in the waiting room.

Older people

Good

Updated 26 July 2016

The practice is rated good for the care of older people.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.

  • The practice was responsive to the needs of older people, and offered home visits for those with enhanced needs.

  • The practice were linked to care homes in the area were they had patients residing at and worked closely with the care home staff to provide reviews and home visits where necessary.

Working age people (including those recently retired and students)

Good

Updated 26 July 2016

The practice is rated good for the care of working-age people (including those recently retired and students).

  • The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

  • Telephone consultations were available and the GPs used mobile telephones so the incoming calls were not affected.

People experiencing poor mental health (including people with dementia)

Good

Updated 26 July 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia).

  • 90% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the CCG average of 86% and the national average of 84%.  
  • 94% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the national average of 88%.

  • The practice carried out advance care planning for patients with dementia.

  • The practice were able to refer to a mental health nurse.

  • The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 26 July 2016

The practice is rated good for the care of people whose circumstances may make them vulnerable.

  • The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

  • The practice offered longer appointments for patients with a learning disability.

  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.

  • Staff knew how to recognise signs of abuse in vulnerable adults and children. 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.