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Parkbury House Surgery Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 May 2020

We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

This inspection focused on the following key questions: safe, effective and well-led.

Because of the assurance received from our review of information we carried forward the ratings for the following key questions: caring and responsive.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected,
  • information from our ongoing monitoring of data about services and,
  • information from the provider, patients, the public and other organisations.

We rated the practice as requires improvement overall, with ratings of inadequate for providing safe services and requires improvement for providing effective and well-led services. We rated the practice as requires improvement for the people with long-term conditions and w

orking-age people (including those recently retired and students)

population groups and good for all other population groups.

We rated the practice as inadequate for providing safe services because:

  • Staff did not always have the information they needed to deliver safe care and treatment. Not all pathology test results, including those older than one week, were clearly identified as reviewed and actioned or awaiting further action.
  • The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation, were not always comprehensive. The process for monitoring patients’ health in relation to the use of high-risk medicines with the appropriate monitoring and clinical review prior to prescribing was insufficient.
  • The system for acting on safety alerts was not comprehensive.

We rated the practice as requires improvement for providing effective services because:

  • The practice’s quality monitoring and improvement systems were not always effective at identifying and resolving issues, concerns, or below averages performance.

We rated the practice as requires improvement for providing well-led services because:

  • The practice did not always have effective governance structures, systems, and processes in place. This included those in relation to staff DBS checks, staff vaccinations, staff training, fire safety systems, Legionella management, the control of water temperatures, the monitoring of blank prescription stationery, the management of pathology test results, the monitoring and review of patients prescribed high-risk medicines, and the system for acting on safety alerts.

Please see the final section of this report for specific details of our concerns.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Please see the final section of this report for specific details of the action we require the provider to take.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection areas

Safe

Inadequate

Effective

Requires improvement

Caring

Good

Updated 16 March 2016

The practice is rated as good for providing caring services.

  • Data from the National GP Patient Survey from January 2016 showed patients rated the practice similar to local and national averages for several aspects of care and lower for others. The results from the survey were not consistent with our findings during the inspection. All of the patients we spoke with or who left comments for us were very positive about how the GPs and nurses listened to them, involved them in decisions about their care and treated them with care and concern.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect and maintained patient and information confidentiality.

Responsive

Good

Updated 16 March 2016

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.
  • Data from the National GP Patient Survey from January 2016 showed patients rated the practice better than local and national averages for several aspects of access and worse for others. For example, patients thought access to the practice by phone was better than average but being able to see or speak with a preferred GP was worse than average. The patients we spoke with or who left comments for us were very positive about access to the practice and appointments. They told us they liked the appointments system at the practice as they were seen quickly and efficiently by the appropriate clinician.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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 and other stakeholders.

Well-led

Requires improvement
Checks on specific services

People with long term conditions

Requires improvement

Families, children and young people

Good

Older people

Good

Working age people (including those recently retired and students)

Requires improvement

People experiencing poor mental health (including people with dementia)

Good

People whose circumstances may make them vulnerable

Good