This practice is rated as Good overall.

We previously inspected the practice in March 2015 when we rated them good overall and for all the key questions.

The key questions are rated as:

• Are services safe? – Good
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? - Good

We carried out an announced comprehensive inspection at the Avenue Surgery Partnership on 15 May 2018, as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• The practice proactively identified patients who were carers, including young carers. This group of patients were offered additional support.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had a Domestic Abuse policy and had developed services to support this.
• The practice was working with the local authority on the national programme to resettle Syrian refugees. They were providing care for a number of families in the area.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review the newly implemented system for sharing learning points from complaints and significant events to ensure it is effective.
• Review their complaints procedure and it’s implementation against best practice guidance.
• Review their newly implemented system for monitoring the distribution and use of blank handwritten prescription forms to ensure it is effective and in line with recognised guidance.
• Review their system for the recording and governance of staff training the practice considers essential

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Avenue Surgery Partnership (Avenue Road Surgery) on 2 March 2015. Overall the practice is rated as Good. We found the practice to be good for safe, effective, caring, responsive and well led services for all of the population groups.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Overall risks to patients were assessed and generally well-managed, with the main exception of those risks relating to infection control.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Data showed patient outcomes were generally above or equal to the average for the locality. Although some audits had been carried out in 2014, data was not yet available to demonstrate that audits were driving improvement in performance to improve patient outcomes.
• Patients said their GP treated them 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and overall staff felt supported by management. The practice proactively sought feedback from staff and patients, which it had started to act on.
• The practice was involved in the productive GP Practice programme to improve patient services and practice efficiency.
• The practice was a research practice and participated in a number of research studies which had a potential impact on patient outcomes.
• Urgent appointments were usually available on the day they were requested. However, patients said that they sometimes had to wait up to two weeks for non-urgent appointments. In addition access to the practice via telephone was difficult.
• Infection control practice was not consistently followed in line with national guidance or practice policy.
• The practice employed a nurse specifically to assess, monitor and support patients over 75 years of age including assessments for frailty.
• GPs met with care home staff every two months to share best practice and training. Speakers were invited and topics covered a range of topics such as palliative care and medicines management.

We saw several areas of outstanding practice including:

• GPs had for a number of years recorded health education interviews for a local radio station. The topics covered included suggestions from the public and national public health initiatives.
• There were over 680 (4%) carers on the carers register and a designated member of staff to enable carers to be supported. The staff member had appeared on local radio to talk about the support that was available which included specific information and advice for carers and health reviews.

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

The provider should:

• Undertake a risk assessment regarding the location of emergency equipment.

• Continue to develop and review patient access for making and securing appointments.
• Ensure staff understand their role and responsibilities with regards to infection prevention and control requirements.
• Review patient group direction (PGD) records to ensure they do not include out of date PGDs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice