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Review carried out on 3 December 2019

During an annual regulatory review

We reviewed the information available to us about The Crescent Surgery on 3 December 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 16 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Crescent Surgery on 16 August 2016. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However, discussions of these events were not always documented and the practice did not always make whole system changes or systematically review actions taken.
  • Feedback from patients about their care was consistently positive. All of the patient comment cards that we received praised the practice and said that staff were kind and professional.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. They offered a bookable treatment room service every day that was shared with the neighbouring practice and the community district nursing service.
  • The information needed to plan and deliver care and treatment was available to staff through the practice’s patient information system, however, not all written communication was seen by the GPs or senior clinical staff as would be expected.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, they had introduced a same day clinic for minor ailments that was run every day by the nurse practitioners.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. The GP partners, together with the neighbouring practice partners had invested in extending the property, aided by National Health Service funding and building work was underway at the time of our inspection.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
  • The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice:

  • The practice employed a qualified nurse as a care co-ordinator who contacted all patients who had been discharged from hospital, providing a home visit and full assessment if necessary. This had achieved a reduction of 22% in unplanned admissions to hospital in the year prior to June 2016. The clinical commissioning group (CCG) adopted this model of care for other practices for 2016-2017.
  • The practice proactively identified any patients who were over 75 years of age and had not been seen in the practice for healthcare within the last year. They reviewed the needs of these patients and invited them for a health assessment.
  • The practice had purchased a light box to facilitate staff training and hand hygiene. (A light box enables staff to identify poor hand hygiene practices).
  • The practice had recognised patient difficulties in accessing appointments and had introduced an open clinic for patients with minor ailments every day from 8.30am to 11.30am run by nurse practitioners. Patients told us that they thought this was an excellent service. We were told that the practice planned to introduce an open clinic at a later time for working patients.
  • The practice had identified 404 patients as carers (4.7% of the practice list) and had been recognised as carer friendly by the local carers’ network organisation. That organisation also held a weekly clinic for carers in the practice.

However there were areas of practice where the provider should make improvements:

  • The practice should put systems in place so that all items of communication received by the practice were seen by the GPs or senior clinical staff before being filed.
  • Discussions of significant events should be recorded and actions identified by significant event reports should be put in place and checked to be effective.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice