The Care Quality Commission
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  • GP practice

Archived: Dr A R Bridge and Partners

Overall: Good read more about inspection ratings

Church Street Surgery, Church Street, Martock, Somerset, TA12 6JL (01935) 822541

Provided and run by:
Dr A R Bridge and Partners

Important: The provider of this service changed. See new profile

All Inspections

21 March 2018

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Dr A R Bridge & Partners (which at that time was known as Dr J R Buckle and Partners) on 18 February 2016. The overall rating for the practice was requires improvement. A follow up inspection was carried out on 29 June 2017. The overall rating for the practice was good, however, the effective services were found to require improvement. The report on the full comprehensive inspection in February 2016 and the follow up inspection in June 2017 can be found by selecting the ‘all reports’ link for Dr A R Bridge & Partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good overall and good for providing effective services.

Our key findings were as follows:

  • There are systems in place to ensure all persons employed received appropriate training, relevant to their role. For example, we saw records showing all staff are trained in safeguarding adults, safeguarding children and fire safety.
  • The provider had reviewed administrative systems to improve telephone access to non-urgent appointments.

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

  • Continue to review arrangements to improve telephone access to non-urgent appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

29 June 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr A R Bridge and Partners, which at that time was known as Dr J R Buckle and Partners, on 18 February 2016. The practice is also known as Martock Surgery. The overall rating for the practice was requires improvement. The full comprehensive report on the February 2016 inspection was published on 13 October 2016 and can be found by selecting the ‘all reports’ link for Dr A R Bridge and Partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 29 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 18 February 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good. At this Inspection the practice was rated as good for providing safe, responsive and well-led services and requires improvement for providing effective services.

Our key findings were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • The practice had safe systems of infection prevention and control and staff had received appropriate infection prevention and control training.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. The practice demonstrated that staff understood their roles and responsibilities according to policies and procedures. The practice had now embedded systems of good governance to monitor and improve the quality of services provided to patients.
  • The practice had completed a Disclosure and Barring Service (DBS) check for all staff. Staff that acted as chaperones had completed relevant training to support them in this role.
  • An overarching governance framework supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • Staff had received inductions, annual performance reviews and attended staff meetings and training opportunities.
  • The partners encouraged a culture of openness and honesty. The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.
  • The practice proactively sought feedback from staff and patients and we saw examples where feedback had been acted on. The practice engaged with the patient participation group.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Ensure there are systems in place for staff training relevant to each role. For example, to ensure staff are trained in safeguarding adults, safeguarding children and fire safety.

In addition the provider should:

  • Review administrative systems to improve telephone access to non-urgent appointments.

At our previous inspection on 18 February 2016, we rated the practice as requires improvement for providing effective services as not all staff had received training necessary to undertake their roles and responsibilities. At this inspection we found that not all staff had completed training in safeguarding adults, safeguarding children and fire safety, consequently the practice is still rated as requires improvement for providing effective services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 February 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr J R Buckle & Partners on 18 February 2016. Overall the practice is rated as requires improvement .

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

  • There was an open and transparent approach to safety, however, the practice should review arrangements for reporting and recording significant events.
  • Risks to patients were assessed and managed with the exception of those relating to infection prevention and control.
  • The practice participated in a local quality and outcomes framework, Somerset Practice Quality Scheme (SPQS), rather than the Quality and Outcomes Framework (QOF), to monitor practice performance and outcomes for patients.
  • Some audits had been carried out, however, we saw little evidence that audits were driving improvements to patient outcomes. We did not see evidence that consistent ways of working were in place for GPs, in order to reduce the risk of errors.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Most staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. However, we found some gaps in training including infection prevention and control and for chaperones.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • 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.
  • Patients said they often found it difficult get through to the practice by telephone to make an appointment. Urgent appointments were available the same day and there was continuity of care available with a named GP.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on. However, we did not see evidence that adequate non-clinical management time was in place for partners and other clinical supervisors. Governance arrangements should be improved to ensure they are effective.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

  • Ensure arrangements for infection prevention and control, including risk assessments, are in place taking appropriate corrective action where required.

  • Ensure there are systems in place for staff training relevant to each role; and ongoing staff supervision and support. For example, to ensure staff are trained in infection prevention; and all staff receive adequate supervision and appraisal.

  • Ensure arrangements for the recording of significant events to provide consistency, accuracy and completeness, including action plans and lessons learnt.

  • Review the leadership arrangements to ensure adequate non-clinical management time in place for partners and other clinical supervisors to deliver all responsibilities and improvements.

  • Ensure governance arrangements, including systems and processes to monitor and improve quality and safety such as clinical audit are improved.

The areas where the provider should make improvements are:

  • Review clinical capacity and administrative systems to improve the availability of and telephone access to non-urgent appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 September 2013

During a routine inspection

We visited the provider's main location of Martock Church Street Surgery and the branch location of South Petherton Medical Centre. We reviewed records and systems and looked at the environment and how this impacted on the service delivery. We spoke with eight patients, and observed interaction between staff and patients. We spoke with both clinical and non-clinical staff and managers .We found that patients were satisfied with the care and treatment they received and told us they were treated with respect. One patient told us 'I see the same GP each time I come. He gives you the time, you never feel rushed'. We were told by another patient 'There are no worries with privacy here.'

The provider ensured that a clean, safe environment was maintained for patients and staff.

Staff had received training in order to maintain their clinical skills. All staff had completed training in safeguarding of vulnerable adults and the protection of children.They were able to describe the possible signs that abuse was occurring. The provider had suitable arrangements in place to ensure that staff received appropriate training to deliver care and treatment safely.

The provider had systems in place to monitor the effectiveness and quality of the services being provided. People who used the service and staff were asked for their views about their care and treatment and they were acted on.