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Archived: Parkhall Surgery Good

Inspection Summary


Overall summary & rating

Good

Updated 13 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 18 May 2016. We set a requirement in relation to safe care and treatment. The practice sent in an action plan informing us about what they would do to meet legal requirements in relation to the following;

  • The practice must introduce an audit trail for prescription pads and computer forms so that they can monitor their use in line with national guidance.

During the initial inspection we also found areas where improvements should be made:

  • Implement a formal system to disseminate The National Institute for Health and Care Excellence (NICE) guidance and ensure all clinicians are aware of any updates.
  • Ensure that dispensary staff are supported to keep up to date, and that they are regularly assessed as competent to carry out their role.
  • Establish an effective process for monitoring the quality of the dispensing process including reviewing errors and near misses for learning.

The practice told us these issues were addressed by 20 May 2016 and have provided us with evidence to show they had taken the action to address the concerns.

We undertook a desk top review on 13 December 2016 to make a judgement about whether their actions had addressed the requirements.

The overall rating for the practice is good. You can read our previous report by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 13 January 2017

At the last inspection on 18 May 2016 we found that:

  • The practice must introduce an audit trail for prescription pads and computer forms so that they can monitor their use in line with national guidance.

During the initial inspection we found areas where improvements should be made:

  • Implement a formal system to disseminate NICE guidance and ensure all clinicians are aware of any updates.
  • Ensure that dispensary staff are supported to keep up to date, and that they are regularly assessed as competent to carry out their role.
  • Establish an effective process for monitoring the quality of the dispensing process including reviewing errors and near misses for learning.

Our focused inspection on 13 December 2016 found that:

The practice is rated as good for providing safe services.

  • We saw evidence of an effective audit trail established. Blank prescription forms and pads were securely stored and there were systems in place to monitor their use. Serial numbers were recorded on a spread sheet on receipt of the prescriptions and the destination and who received them were logged.
  • The practice discussed NICE Guidance as a standing agenda in their monthly clinical meetings.
  • We saw evidence of a form created to annually assess the competency of the dispensing team which was completed by the lead dispensing GP. The assessment had taken place on both of the practices’ dispensers.
  • The dispensers logged in a book near misses and errors. Errors were recorded as significant events and were discussed in regular clinical meetings.

This report should be read in conjunction with the full inspection report from 18 May 2016.

Effective

Good

Updated 20 June 2016

  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • There were joint working relationships with community services and engagement with health and social care providers to co-ordinate care and meet patients’ needs.

Caring

Good

Updated 20 June 2016

  • Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care. For example 94% said the last GP they saw was good at listening to them; 94% said the last nurse they saw was good at treating them with care and concern.
  • Patients told us they were treated in a respectful and empathetic way by the practice’s staff.
  • We found many examples where staff had gone out their way to support patients, both practically and emotionally.

Responsive

Good

Updated 20 June 2016

  • The practice offered a range of services and was well equipped to treat patients and meet their needs.

  • Patients said they found it easy to make an appointment there was continuity of care, with urgent appointments available the same day.
  • 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 20 June 2016

  • Staff were supported and well managed at all times, and there were clear lines of responsibility and accountability within the practice .
  • The practice had a number of policies and procedures to govern its activity and held regular governance meetings.
  • Staff had received inductions, regular performance reviews and attended staff meetings and events.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The practice sought feedback from staff and patients, which it acted on. The patient participation group was active and met regularly to make suggestions for improvements.
Checks on specific services

People with long term conditions

Good

Updated 20 June 2016

The practice is rated as good for the care of people with long-term conditions. There was an effective patient recall system in place to ensure that patients’ health needs were reviewed. A specialist diabetic nurse visited the practice each month and there were regular virtual consultations with a consultant. Longer appointments and home visits were available when needed and patients at risk of hospital admission were identified as a priority. GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care to patients with the most complex needs.

The practice was part of a scheme to ensure patients had access to ‘just in case’ medicines in the evening and at week-ends.

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Families, children and young people

Good

Updated 20 June 2016

The practice is rated as good for the care of families, children and young people. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice worked well with local health visitors, midwives and school nurses to offer a full health surveillance programme for children. Immunisation rates were relatively high for all standard childhood immunisations. Information was available specifically for young people questioning their sexuality or gender identity.

Older people

Good

Updated 20 June 2016

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, dementia and avoiding unplanned hospital admissions.

Working age people (including those recently retired and students)

Good

Updated 20 June 2016

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of these patients been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. Appointments were available with the GPs and nurses from 8.30am each morning and the practice opened till 8pm every Monday evening. The dispensary was open until 6pm each evening.

A full range of health promotion and screening that reflected the needs for this age group was available.

People experiencing poor mental health (including people with dementia)

Good

Updated 20 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice performed well in indicators for dementia and mental health. Patients with significant mental health problems had annual mental health and medicines reviews.

The practice provided rooms for a range of mental health professionals to use to see patients, including those from the Gainsborough Foundation (alcohol support), and the IAPT team (independent access to psychological therapy).

People whose circumstances may make them vulnerable

Good

Updated 20 June 2016

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