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Dr Hutchings and Partners Good

Inspection Summary


Overall summary & rating

Good

Updated 1 February 2017

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Dr Hutchings and Partners on 27 April 2016. The practice was rated as requires improvement for providing safe care and well led services and good for being effective, caring and responsive. The practice was rated as requires improvement overall. This was because we found that there was not always clear documentation of significant events or of the meetings where these were discussed; the practice’s significant events policy was not followed and not all staff attended the meetings. The practice did not carry out annual reviews of significant events to identify trends. In addition, there was not always adequate monitoring and mitigation of risks relating to fire, gas and electrical appliance safety. It was also found that the monitoring of training was weak, and not all staff had completed up to date training relevant to their roles, such as safeguarding children and adults, health and safety and infection control.

Following the inspection 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 in relation to significant events, premises safety and staff training.

In addition to the regulation breach, during the inspection in April 2016, we made recommendations of best practice to address some minor areas of concern. Whilst the practice was rated as good for providing effective and responsive services, we recommended that the practice reviewed its decision making process for exception reporting of some patients with long-term conditions. (Exception reporting is the removal of patients from Quality and Outcomes Framework calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects). We also recommended that they took steps to enable patients with disabilities, hearing difficulties and those whose first language is not English, to access the surgery services more easily.

We carried out a desktop inspection of Dr Hutchings and Partners in December 2016 to assess whether the practice had made the recommended improvements. We found the practice was able to demonstrate that they were meeting the standards for safe care and well led services. In particular;

  • There were systems in place to ensure that learning from significant events was clearly documented and disseminated throughout the practice to all relevant staff.

  • Risks relating to fire, gas and portable electrical appliance safety had been assessed and mitigated.

  • All team members were up to date on statutory training to ensure the safety and wellbeing of patients and staff.

  • The practice provided evidence that they had improved the governance arrangements for recruitment and had requested suitable references for new personnel.

The practice was also able to demonstrate they were working towards improving their exception reporting figures through increased communication with their patients. They had initiated a text reminder service in November 2016 to call patients in for annual review and commenced a personalised telephone reminder service for some patient groups. These systems were reported to be working well, although the initiatives had occurred too recently to offer any comparable data. They had also reviewed the patient equality and accessibility issues and had undertaken repair work to the automatic entrance doors to make access easier for less able bodied patients. They had access to a telephone based interpretation service and all staff were aware how to access it for their patients. Although a hearing loop was not yet available, the GP partners had agreed it was necessary and the practice manager was looking at availability and pricing.

We have updated our ratings to reflect these changes. This report should be read in conjunction with the full inspection report.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 1 February 2017

The practice is now rated as good for providing safe services.

Since our last inspection in April 2016, the practice was found to have undertaken work to address matters of concern around significant events, fire, gas and electrical appliance safety, and staff training and references:

  • The practice ensured that the discussion of significant events was added to the agenda for all general staff and monthly clinical meetings. These were minuted, and records saved electronically and on a hard copy accessible to all staff.

  • The practice had the fire safety systems reviewed, including testing of the fire alarms and emergency lighting, servicing of fire extinguishers, introducing weekly checks for fire alarms and emergency lighting, and recording fire drills.

  • The practice had a new gas boiler fitted in October 2016, for which a Buildings Regulations Compliance Certificate had been received.

  • They had arranged for Portable Appliance Testing (PAT) to be undertaken on all relevant electrical equipment in May 2016, and setting up a contract to ensure that this is repeated on an annual basis.

  • The practice showed us evidence that governance arrangements were being followed regarding recruitment. We saw that suitable references were being sourced and retained.

Effective

Good

Updated 1 February 2017

Caring

Good

Updated 1 February 2017

Responsive

Good

Updated 1 February 2017

Well-led

Good

Updated 1 February 2017

The practice is now rated as good for providing well led services.

Since our last inspection in April 2016, the practice was found to have undertaken work to address matters of concern around leadership and governance by:

  • Putting in place the additional processes required to fully ensure that risks relating to patient safety were mitigated and that the service was responsive to all patients’ needs.

  • There was now clear documentation of significant events, which were discussed regularly at meetings which could be attended by all staff, and minuted for those who had been unable to attend.

  • Risks relating to the operation of the premises, including fire, gas and portable electrical appliances were assessed and mitigated.

  • They ensured that all staff were fully up to date on statutory training, including safeguarding, health and safety and infection control, with certificates kept in their personnel files.

Checks on specific services

People with long term conditions

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Families, children and young people

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Older people

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Working age people (including those recently retired and students)

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People experiencing poor mental health (including people with dementia)

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People whose circumstances may make them vulnerable

Good

Updated 1 February 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 April 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.