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Dr Bouch and Partners Good Also known as Bridge Road Surgery

Inspection Summary


Overall summary & rating

Good

Updated 8 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection report published 3 September 2015 - Good)

The key questions are rated as:

Are services safe? – Good

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 Dr Bouch and Partners on 6 December 2017 as part of our regulatory functions.

At this inspection we found:

  • The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes.
  • Effective monitoring processes were in place, which included for example, health and safety, recruitment, training and appraisals. The practice had three non clinical staff who had not attended the recent basic life support refresher training and two staff who had been off sick when their appraisal was scheduled. However the practice were aware of this and had scheduled these to be completed.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines. Support and monitoring was in place for the clinical pharmacist and nursing staff, and the monitoring of the work undertaken by the nurse practitioners was formalised and effective.
  • Staff treated people with compassion, kindness, dignity and respect and involved them in decisions about their care and treatment. All staff had received equality and diversity training. The practice patient information leaflet was available in large print and audio format.
  • Patients found the appointment system easy to use and reported that access to appointments was positive; this was supported by a review of the appointment system and data from the National GP Patient Survey. The practice were aware of patient feedback in relation to the length of waits once patients had arrived for their appointment. This had been discussed with all the GPs and informal and formal feedback mechanisms were agreed.
  • The practice had responded to the needs of patients and suggestions from staff. We saw a number of examples of this including health checks for patients with a learning disability being undertaken in their own home, raising the height of the patient toilet and changing the days practice meetings took place.
  • Information on the complaints process was available for patients at the practice and on the practice’s website. There was an effective process for responding to, investigating and learning from complaints.
  • Staff had the skills, knowledge and experience to carry out their roles and there was a strong focus on continuous learning and improvement at all levels of the organisation. Staff we spoke with felt supported by the practice.

The areas where the provider should make improvements are:

  • Ensure the non-clinical staff members complete the planned basic life support refresher training.
  • Monitor the exception rates for the quality and outcomes framework data, with the aim to reduce this over time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 8 January 2018

Effective

Good

Updated 8 January 2018

Caring

Good

Updated 8 January 2018

Responsive

Good

Updated 8 January 2018

Well-led

Good

Updated 8 January 2018

Checks on specific services

People with long term conditions

Good

Updated 3 September 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff were experienced and well trained in chronic disease management, and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were easily available when needed. Patients had a named GP and a structured annual review to check that their health and medication needs were being met. There was an efficient and effective recall system in place. For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care. Acupuncture was provided to those with chronic musculoskeletal conditions.

Families, children and young people

Good

Updated 3 September 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify children living in disadvantaged circumstances and who were at risk. Immunisation rates were good for all standard childhood immunisations and the practice offered a weekly walk in vaccination clinic. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered a wide range of family planning advice and treatment to all age groups. There was a chlamydia screening service for 15-24 year olds.

Older people

Good

Updated 3 September 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. It had built up effective relationships with the care homes it provided services to.

Working age people (including those recently retired and students)

Good

Updated 3 September 2015

The practice is rated as 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 reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 3 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 63% of people experiencing poor mental health, and 89% of those living with dementia had received an annual physical health check. People with mental health problems were invited to attend a combined appointment to see the nurse initially, and then a 30 minute appointment with a GP to review their physical and mental health. A large number of staff had attended a dementia awareness training session provided by the local Alzheimer’s association. Further training was planned to increase staff’s awareness of mental health.

People whose circumstances may make them vulnerable

Good

Updated 3 September 2015

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

The practice held a register of patients living in vulnerable circumstances including those with a learning disability. However only 60% of patients with learning disabilities had received an annual health check, and none had been given a health action plan, outlining how their health care needs would be met.