This practice is rated as Good overall. We previously carried out an announced comprehensive inspection at Brandon Medical Practice on 8 August 2017. The overall rating for the practice was requires improvement (safe, caring, responsive and well led were rated as requires improvement, effective rated as good).

We carried out an announced comprehensive inspection at Brandon Medical Practice

on 27 March 2018 to check that the provider had made the improvements required from the last inspection. Overall, the practice is now rated as good. The full reports on the August 2017 inspection can be found by selecting the ‘all reports’ link for Brandon Medical Practice on our website at www.cqc.org.uk.

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

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

At this inspection we found:

• The practice is a member of the Suffolk Primary Care (SPC) partnership which is a partnership that consists of 11 GP practices. Through joint working the practice had extended their skill mix within the practice with first point physiotherapists and an emergency care practitioner.
• The practice had responded to patient’s feedback and held surgeries on one Saturday morning each month. Patients also had access to evening and weekend appointments at the GP+ service which operated in nearby Bury St Edmunds and Ipswich.
• There was an open and transparent approach for reporting and recording significant events and information was shared with the Suffolk Primary Care partnership for wider learning. The practice was working towards more joint meetings within the practice to ensure whole team reviews of events.
• The practice had good facilities and was equipped to treat patients and meet their needs. The practice had responded to patient feedback and had recently redecorated through the main building.
• There were arrangements for identifying, recording, and managing risks, issues, and implementing mitigating actions.
• A programme of continuous clinical and internal audit was used to monitor quality and to make improvements. In addition to the practice programme, there was a programme of audits across all the practices within Suffolk Primary Care partnership.
• Practice specific policies were implemented; the practice was in the process of migrating to the policies and procedures under the Suffolk Primary Care partnership governance. We saw evidence that this was being managed safely and systematically.
• All medicines we checked were in date and regular checks were undertaken.
• The practice had a system in place for handling complaints and concerns. We looked at documentation relating to complaints received in the previous six months and found that they had been fully investigated and responded to in a timely and appropriate manner.
• Data from the National GP Patient Survey, published in July 2017, showed patients rated the practice below average for most aspects of care. Since our previous inspection the practice had undertaken two patient surveys with improved results.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff, which it acted on. Staff told us they were able to undertake development opportunities.
• Staff were supported through a system of appraisals and continued professional development.
• Since our last inspection the practice had formed a patient participation group and we spoke with three members who gave positive feedback on the practice.
• The provider was aware of, and had systems in place to ensure, compliance with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review and improve the uptake for childhood immunisations, specifically those relating to children aged two receiving the pneumococcal vaccine.

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 the Brandon Medical Practice on 8 August 2017. 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 for reporting and recording significant events.
• The practice had good facilities and was equipped to treat patients and meet their needs.
• There were arrangements for identifying, recording and managing risks, issues and implementing mitigating actions; however these arrangements were not always effective.
• A programme of continuous clinical and internal audit was used to monitor quality and to make improvements. We found the audit programme to be of limited scope and not always focussed on the most recent guidance available.
• The practice’s use of the computer system required improvement to provide improved assurance around patient recall systems.
• Practice specific policies were implemented and were available to all staff in paper form. Due to the practice’s recent transition into the Suffolk Primary Care (SPC) partnership, there were a mix of SPC’s and the practice’s previous policies, including two for safeguarding, which created the risk of confusion over which policies were in use. The practice advised this would be addressed immediately.
• The practice had a system in place for handling complaints and concerns. Its complaints policy was in line with recognised guidance and contractual obligations for GPs in England. We looked at documentation relating to complaints received in the previous 16 months and found that they had been fully investigated and responded to in a timely, but not always in an empathetic manner.
• Data from the National GP Patient Survey, published in July 2017, showed patients rated the practice below average for most aspects of care. Feedback from patients was mixed and the practice did not have an active Patient Participation Group (PPG).
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff, which it acted on. Staff told us they were able to undertake development opportunities.
• Staff were supported through a system of appraisals and continued professional development. Staff informed us they felt well supported.

The areas where the provider must make improvement is:

• 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.

The areas where the provider should make improvement are:

• Effectively track blank prescription stationary through the practice.
• Review patients with learning disabilities, those with dementia or experiencing poor mental health in a timely manner.
• The current audit programme should be reviewed to take into account current evidence based guidance.
• Review the recording and coding of medical records to ensure accurate and reflective care and treatment of patients, including patients who are carers.
• Continue patient engagement to establish an active patient participation group.

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 Brandon Medical Practice on 31 August 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Information about services and how to complain was available and improvements were made to the quality of care as a result of complaints and concerns.
• GPs visited local care homes in order to provide treatment for their registered patients who lived there. We spoke with staff at one of the care homes and they told us that they received ‘excellent’ responsive person-centred care.
• The practice had recently reviewed processes and protocols relating to governance to make improvements.
• The practice was well equipped to treat patients and meet their needs.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• Practice staff told us that they felt supported by the practice partners and management team.

The areas where the provider should make improvement are:

• Update the infection control protocol to reflect changes in practice policy in dealing with spillages.

• Continue to investigate ways to increase appointment availability.

• Continue to embed, monitor, and evaluate new systems and processes that had been introduced recently. This includes, practice staff induction and training programme and infection control.

• Develop ways to increase the number of carers that the practice has registered to ensure that they receive appropriate support.

• The practice should continue to attempt to establish an active Patient Participation Group.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice