Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brotton Surgery, Alford road, Brotton, Saltburn By The Sea, Cleveland TS12 2FF on 3 December 2018. Our inspection team was led by a CQC inspector and included a GP specialist advisor and a second CQC inspector.

Our judgement of the quality of care at this service is based 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.

We concluded that:

• Systems were in place to report, record and disseminate learning from significant events and complaints.

• Staff worked to clear protocols and evidence based clinical guidance to meet patients’ needs.

• Quality improvement activity was carried out which resulted in improved outcomes for patients.

• Staff treated patients with courtesy and respect. Feedback from patients confirmed this.

• The leadership, governance and culture of the practice promoted an inclusive supportive environment for staff.

• Patient satisfaction was high in all areas of the service provided by the practice. Patients survey results were very high. The practice had been ranked 4th in Teesside for the national patient data survey (July 2018).

Whilst we found no breaches of regulations, the area where the provider should make improvements is:

• There was evidence of an infection control audit and some areas were identified as needing improvement. However, there was no action plan in place to show the areas identified had been addressed.

We saw an area of outstanding practice:

• A clinician in the practice had added further ‘pop up’ boxes on their clinical system within their templates. We were told that this reduced variability in coding as well as improving the safety of work carried out by new members of staff, clinical trainees and locums. The templates also promoted patient safety through prompts for clinicians during and after consultations to ensure referrals and investigations were completed.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

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 Brotton Surgery on 2 May 2015. Overall the practice is rated as good. Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for the people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). We found the care of older people to be outstanding.

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 and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

The practice provided medical cover for the local community hospital beds. Where they were able to admit, transfer and manage their own patients. The practice also worked in partnership with the local consultant Geriatrician in the management of patients in the community hospital. The GPs and consultant Geriatrician had admitting rights to the community hospital beds. This also facilitated access to the expertise of the consultant in managing their patients. They were also able to refer and manage patients as part of the virtual ward managed by the community matron. The community matron was not employed by the practice.

Action the provider SHOULD take to improve:

The checking process for controlled medication was incomplete.

The cleanliness of the medicine cupboard was not monitored.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice