This practice is rated as Good overall. (Previous inspection October 2015 – Good)

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

We carried out an announced comprehensive inspection at Carisbrooke Health Centre on 20 March 2018, as part of our inspection programme.

At this inspection we found:

• The practice had clear 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.
• 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.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• The practice child safeguarding lead GP held monthly meetings with the School Nurse, the Health Visitor and the community learning disability team liaison to discuss any issues.
• The practice was equipped to deal with medical emergencies and staff were suitably trained in emergency procedures.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

The areas where the provider should make improvements are:

• Review the recording of the decision to not undertake a Disclosure and Barring Service check on some staff roles.
• Review the process for the approval of all Patient Specific Directions completed for health care assistants in relation to flu injections.
• Review how patients are informed of the practice’s complaints process, including how to contact the Parliamentary and Health Service Ombudsman.

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 Carisbrooke Health Centre on 28 October 2015. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• 90.2% said the last GP they saw was good at explaining tests and treatments compared to the CCG average of 88.6% and national average of 86%.
• 94.7% said the GP gave them enough time (CCG average 88.6%, national average 86.6%).
• 98.7% said they had confidence and trust in the last GP they saw (CCG average 96.4%, national average 95.2%)
• 93.4% said the last GP they spoke to was good at treating them with care and concern (CCG average 89.2% national average 85.1%).
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice identified that the podiatry appointments were not enough for the population. A health care assistant had received training to do lower limb assessment to make up for that reduction in the community service.

The areas where the provider should make improvement are:

• Ensure that health and safety risk assessments are regularly reviewed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During this inspection we looked at how staff were recruited and the checks which were completed before new staff commenced working at the practice. This was because when we previously visited in October 2013 they were not compliant with this area.

We found the practice now had appropriate systems in place and evidence was seen which confirmed these systems had been followed. Pre-employment checks had been completed to ensure a new staff member was suitable to work with vulnerable people.

We spoke with 15 patients who were attending the surgery during our inspection. We also spoke with the two of the seven GP partners, practice manager, practice nurses, and six administrative staff. All patients were extremely happy with the service they received from the health centre and the staff. They told us they could always get an appointment when they needed one and there was adequate time at each consultation.

All patients said they were treated appropriately and with dignity and respect. Patients were protected against the risks of receiving care or treatment which was inappropriate or unsafe. Patients said treatment options were fully discussed and explained to them.

There were suitable arrangements in place for all staff to be able to recognise and report safeguarding children and vulnerable adults concerns to the relevant authorities. Patients' were protected from the risk of infection because appropriate guidance and procedures were followed.

Patients were cared for by suitably qualified, skilled and supported staff. However full pre-employment checks had not been completed on one recently recruited staff member.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of patients using the service and others. Patient’s views were sought as part of the process to monitor the quality of the service provided.