We carried out an announced comprehensive inspection at The Keys Family Practice on 11 February 2020 as part of our inspection programme. On 12 December 2019 we undertook a review of the governance arrangements at provider level and reviewed the corporate policies, procedures and systems in place across the organisation. During this inspection, we looked at whether governance arrangements were embedded and used by staff working at the practice.
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 have rated this practice as good overall, and in safe, caring, responsive and well led, and requires improvement in effective. We rated each population group as good except for families, children and young people and working age people which we rated as requires improvement in the effective domain. This was because the targets for childhood immunisation uptake and cervical cancer screening had not been met.
We found that:
- Patients received effective care and treatment that met their needs and was planned and delivered according to evidence-based guidelines.
- Staff had the skills, knowledge and experience to deliver effective care, support and treatment and worked together and with other organisations to deliver effective care and treatment.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- Patients told us they had seen improvements at the practice, although commented that it was still work in progress. They told us there had been issues with the telephone system, but this now seemed to have been resolved. They also said that the availability of on-line appointments had improved. However, they expressed reservations about reception staff asking the reason for requesting an appointment and did not always wish to share this information.
- Staff told us there had been challenges at the practice following the change in provider. They told us the changes to the staff team had made a real difference to the culture with the practice and morale had improved.
- Staff told us the relationship within the staff team had improved, and staff were supportive of each other. They said the daily huddles had improved communication within the practice.
- The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
- Staff told us that the management team were approachable, and they felt valued and supported in their work.
- There was a focus on continuous learning and improvement at all levels of the organisation. For example: sharing learning from audits, significant events and complaints across the staff team.
Whilst we found no breaches of regulations, the provider should:
- Explore and implement strategies to meet the minimum 90% target for uptake of childhood immunisations.
- Explore and implement strategies to increase the uptake of cervical screening.
- Explore and implement strategies to increase the uptake of breast and bowel cancer screening.
- Proactively identify any young carers.
- Explore and implement strategies to maintain patient confidentiality in the main waiting area.
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