Jubilee Surgery - Care Quality Commission

Background to this inspection

Updated 1 September 2017

Jubilee Surgery is situated in a small town near Fareham, in a semi-rural location. The practice provides a range of primary medical services to approximately 9500 patients and has a general medical services (GMS) contract with NHS England. The GMS contract is the contract between

general practices and NHS England for delivering primary care services to local communities. Jubilee Surgery is a training practice and has doctors on placements who are training to become GPs.

The practice has three male GP partners and one female GP partner. Two of the partners are full time and two are part time. Other members of the clinical team include a nurse practitioner, five practice nurses, and one healthcare assistant. The clinical team are supported by a practice manager and a team of reception and administration staff.

The demographics are similar to the national average, with slightly lower numbers of patients aged 15 to 39 years of age. A large proportion of older patients continue to live in their own homes. The practice is situated in one of the least deprived areas of England and the majority of the population describe themselves as White British. There are small numbers of travellers and patients of no fixed abode who use the practice.

The practice is open between 8.30am and 6.30pm Monday to Friday. Appointments are available during these times. Extended hours appointments are offered on Monday evening between 6.30pm and 7.30pm; and Wednesday morning between 7am and 8.30am. The telephone lines are open from 8am until 6.30pm daily. Out of hours patients are advised to contact the out of hours service via the NHS 111 service.

We inspected the only location at:

Barrys Meadow

High Street

Titchfield

Fareham

PO14 4EH

Overall inspection

Good

Updated 1 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Jubilee Surgery on 5 October 2016. The practice was rated as requiring improvement for providing safe and effective services; and was rated as good for providing caring, responsive and well-led services. As a result, the practice was given an overall rating of requires improvement. Following the comprehensive inspection we issued two requirement notices, due to a breach of the following Regulations:

Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, relating to safe care and treatment;
Regulation 17 of The Health and Social Care Act (Regulated Activity) Regulations 2014, relating to staffing.

Within our last inspection report we stated that the provider must:

Ensure all staff had received training in areas the practice considers are mandatory, including basic life support, safeguarding, information governance and fire safety to a level appropriate to their job role.
Ensure accurate records of training undertaken are maintained.
Ensure arrangements for monitoring of high risk medicines are safe and effective and patients received appropriate care and treatment.
Ensure there are suitable arrangements for monitoring prescription stationery.
Ensure appropriate actions are taken if the vaccine fridge temperatures were outside safe limits.

In addition, we stated that the provider should:

Review the arrangements for monitoring patients with a diagnosis of diabetes, to improve the exception reporting rate, and ensure appropriate care was given.
Review the arrangements for the recruitment of staff in order to demonstrate that all necessary checks had been completed prior to a member of staff commencing employment.
Review the safeguarding policies in order to reflect current organisations.
Review the systems in order to ensure clinical guidance was routinely audited and the practice are able to demonstrate that patients were receiving suitable treatment.
Review the arrangements in order to determine whether child defibrillator pads were needed.
Continue to identify patients who were also carers and the support provided.

The full comprehensive report on 5 October 2016 inspection can be found by selecting the ‘all reports’ link for Jubilee Surgery on our website at www.cqc.org.uk.

We undertook a focused follow-up inspection of the practice on 25 July 2017. The inspection was to confirm that the practice had implemented its action plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

There were key findings across all the areas we inspected during this follow-up inspection. We saw documentary and other evidence that:

All staff had received training in areas the practice considers are mandatory, including basic life support, safeguarding, information governance and fire safety to a level appropriate to their job role.
Accurate records of training undertaken were maintained.
An audit action plan regarding a blood test for patients had been implemented and ensured that arrangements for monitoring of high risk medicines were safe and effective, and patients received appropriate care and treatment.
The practice had suitable arrangements for security and monitoring of prescription stationery.
The practice had a record of appropriate actions taken if vaccine fridge temperatures were outside safe limits.
The practice had reviewed arrangements for monitoring patients with a diagnosis of diabetes, leading to an improved exception reporting rate, and ensuring that appropriate care was given.
Recruitment files had been updated and showed that all necessary checks had been completed prior to any new member of staff commencing employment.
Safeguarding policies were reviewed to reflect current contact information for external organisations who could be involved in any safeguarding issues.
Clinical guidance was followed and routinely audited and the practice was able to demonstrate that patients were receiving suitable treatment.
The practice had a risk assessment in place to determine whether child defibrillator pads were needed.
Continued to identify patients who were also carers and implemented the support they needed.

Following this inspection the practice was rated as good across all domains, which changed its overall rating to Good.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice