Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Castle Healthcare Practice on 22 September 2015. Overall the practice is rated as good.

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

• We inspected the practice within 11 months of being registered with the Care Quality Commission and found significant achievements had been made within a short time to provide a responsive and patient focused service.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. All opportunities for learning from internal and external incidents were maximised.
• 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.

• The practice used proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, they had a robust and patient focussed approach to reviewing the health needs of older people, patients on high risk medicines and people experiencing poor mental health.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Urgent appointments were usually available on the day they were requested. However, patient feedback was mixed in respect of telephone access, availability of routine appointments and waiting times.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had excellent facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. The strategy and business plans to deliver this vision were regularly reviewed and discussed with staff.
• There was a clear leadership structure and staff felt supported by management. High standards were promoted across all roles.

An area of outstanding practice:

• The patient participation group promoted short walks on most Tuesdays leaving the surgery waiting area at 10.30am and again at 11.30am. This was aimed at promoting activity for people who may not otherwise go out for a walk alone and to create friendship opportunities.

However there were areas where the provider should make improvements:

• Improve multi-disciplinary working and communication to ensure patients receive timely and well-coordinated care.
• Improve processes for making appointments including the availability of non-urgent appointments and reducing waiting times.

• Take steps to improve the number of annual health checks undertaken for people with learning disabilities.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice