We carried out an announced comprehensive inspection at Barnburgh Surgery on 13 March 2019 as part of our inspection programme.

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 requires improvement overall and for all population groups.

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

• The practice had not always implemented systems and processes in areas such as recruitment and training and infection prevention and control to keep people safe and safeguarded from abuse.

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

• The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.

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

• The overall governance arrangements were not always effective because policies and procedures had not always been implemented.

These areas affected all population groups so we rated all population groups as requires improvement.

We rated the practice as good for providing caring and responsive services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• There were good levels of patient satisfaction with the service.

The areas where the provider must make improvements are:

• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed. Ensure specified information is available regarding each person employed

The areas where the provider should make improvements are:

• Improve the identification of carers to enable this group of patients to access the care and support they need.
• Review and improve stock control of single use equipment.
• Review and improve systems to monitor delays in referrals.
• Review and risk assess supply of emergency medicines.
• Improve systems to monitor of the outcomes of care and treatment.

• Review the complaints procedure and include the process for escalation of complaints where patients may not be satisfied with the response from the practice.

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