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Swanage Medical Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 23 May 2016

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of Swanage Medical Practice on 14 April 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at Swanage Medical Practice on 26 August 2015 when we rated the practice as good overall. The practice was rated as requires improvement for providing safe care. This was because of how the cleaning cupboard that stored substances potentially harmful to health was managed.

We asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time. The practice was able to demonstrate that they were meeting the standards. The practice is now rated as good for providing safe care. The overall rating remains as good.

This report should be read in conjunction with the full inspection report.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.

Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 23 May 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When things went wrong patients received reasonable support, truthful information, and a written apology. Patients were told about any actions to improve processes to prevent the same thing happening again.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed.

Effective

Good

Updated 23 May 2016

Caring

Good

Updated 23 May 2016

Responsive

Good

Updated 23 May 2016

Well-led

Good

Updated 23 May 2016

Checks on specific services

People with long term conditions

Good

Updated 26 November 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and two nurses had completed a diploma in diabetes care. Longer appointments and home visits were available when needed. The practice also employed a nurse who specialised in cardiac care to manage and monitor the care of patients who had a history of stroke or coronary heart disease. All these patients had a named GP and a structured annual review to check that their health and medicine needs were being met. For those people with the most complex needs, named GPs and nurses worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 26 November 2015

The practice is rated as 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. Immunisation rates were comparable with national averages for children under the age of two. However, data available at the time of our visit indicated that immunisation rates for children under the age of five were low in comparison to the national average. Staff followed up on children who did not attend for immunisations. 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. Appointments were available outside of school hours and the premises were suitable for children and babies. Multi-disciplinary team meetings were held with health visitors and social services.

Older people

Good

Updated 26 November 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 and offered health checks for patients over the age of 75. It was responsive to the needs of older people, and offered home visits, care home visits and rapid access appointments for those who needed them. Multi-disciplinary team meetings were held to discuss the care of older patients and these were attended by community matrons, physiotherapists from the reablement team, district nurses and practice nurses.

Working age people (including those recently retired and students)

Good

Updated 26 November 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 offered evening appointments and some appointments on a Saturday morning but this service was not well advertised. 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.

People experiencing poor mental health (including people with dementia)

Good

Updated 26 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All patients on the mental health register held by the practice had a care plan documented in their records within the last 12 months. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia and supported patients to access support organisations and voluntary organisations. A counselling service was available within the practice. GPs reviewed medicines for patients experiencing poor mental health, prescribing on a weekly basis if required. The practice ran a weekly report to identify patients who had been diagnosed with depression and checked their records to see when they were next due a review.

People whose circumstances may make them vulnerable

Good

Updated 26 November 2015

The practice is rated as 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 a directed enhanced service to patients with learning disabilities and had carried out annual health checks for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. 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.