Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Craneswater Group Practice on 12 April 2016. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the April 2016 inspection can be found by selecting the ‘all reports’ link for Waverley Road Surgery on our website at www.cqc.org.uk.

At the time of our visit in April 2016 the practice inspected was known as Waverley Road Surgery. Since then the provider has changed the name of the practice to Craneswater Group Practice.

As a result of the inspection a warning notice was served. The practice was re inspected in November 2016 and was found to have completed the requirements of the notice.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 10 January 2017. Overall the practice is now rated as Good.

Our key findings 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 managed.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• Risks assessments for areas such as fire and infection control had been carried out, and there was a system to monitor and act on the findings of the assessments.
• Practice policies and procedures were now appropriately reviewed and updated to ensure their content was current and relevant.
• Systems and processes for ensuring all staff were suitably trained had been addressed and the practice had ensured that all staff had the necessary skills and competencies to carry out their role.
• Systems were now in place to monitor the cleanliness of the premises and protect patients from risk of infection.
• There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

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 focussed inspection at Craneswater Group Practice on 10 November 2016 to follow up on a warning notice.

The location was previously known as Waverley Road Surgery.

Our previous inspection in April 2016 was a comprehensive inspection and we rated the practice inadequate overall.

The full report is on our website. The practice was rated as follows:

Good in Caring and Responsive.

Requires Improvement in Effective.

Inadequate in Safe and Well led.

As a result of the inspection a warning notice was served. The timescale given to comply with the warning notice was 30 September 2016.

The warning notice served related to regulation 17 Health and Social Care Act: Good governance.

The areas which did not meet the regulatory requirements were:

• The registered provider did not have suitable systems in place to assess, monitor and improve the quality and safety of services provided in the carrying on of the regulated activity (including the quality of the experience of service users in receiving those services).
• Systems did not assess, monitor or mitigate risks related to health, safety and welfare of service users.
• Systems and processes for ensuring all staff were suitably trained did not ensure that all staff had the necessary skills and competencies to carry out their role.
• We found there were no systematic processes in place to ensure that practice policies and procedures were appropriately reviewed and updated to ensure their content was current and relevant. This did not enable staff to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.
• Systems for monitoring and reviewing significant incidents did not ensure that learning from these incidents was consistently shared with all relevant staff to improve practice.
• Systems in place to monitor risk were not sufficiently robust to ensure that actions needed to minimize risk were in place. Risks assessments for areas such as fire and infection control had been carried out, but there was a failure to monitor and act on the findings of the assessments.
• Systems in place to monitor the cleanliness of the premises did not sufficiently protect patients from risk of infection.
• We found that emergency boxes did not contain the emergency equipment stated on the list, such as cannulas. We also found that the checking system did not monitor sterile use by dates of some emergency medicines to ensure items were replaced as needed.

At our inspection on 10 November 2016 we found the provider had complied with the warning notice and was now compliant with the regulation 17 as set out in the warning notice.

Our Key findings were:

• 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.
• Risks assessments for areas such as fire and infection control had been carried out, and there was a system to monitor and act on the findings of the assessments.
• Practice policies and procedures were now appropriately reviewed and updated to ensure their content was current and relevant.
• Systems and processes for ensuring all staff were suitably trained had been addressed and the practice had ensured that all staff had the necessary skills and competencies to carry out their role.
• Systems were now in place to monitor the cleanliness of the premises and protect patients from risk of infection.
• There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

We have not reviewed the ratings for the practice as part of this inspection. 

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 Craneswater Group Practice on 12 April 2016. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the April 2016 inspection can be found by selecting the ‘all reports’ link for Waverley Road Surgery on our website at www.cqc.org.uk.

At the time of our visit in April 2016 the practice inspected was known as Waverley Road Surgery. Since then the provider has changed the name of the practice to Craneswater Group Practice.

As a result of the inspection a warning notice was served. The practice was re inspected in November 2016 and was found to have completed the requirements of the notice.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 10 January 2017. Overall the practice is now rated as Good.

Our key findings 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 managed.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• Risks assessments for areas such as fire and infection control had been carried out, and there was a system to monitor and act on the findings of the assessments.
• Practice policies and procedures were now appropriately reviewed and updated to ensure their content was current and relevant.
• Systems and processes for ensuring all staff were suitably trained had been addressed and the practice had ensured that all staff had the necessary skills and competencies to carry out their role.
• Systems were now in place to monitor the cleanliness of the premises and protect patients from risk of infection.
• There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with two patients, the three GP partners, one of the practice nurses and the practice management team. Patients we spoke with were all complimentary about the staff and surgery services. We found that although the practice was busy the patients could get an appointment when they needed one, especially the same day. They said “access to the GPs is very good here”. One patient said, “The walk in appointments have always been available as long as you phone before 11am I can get seen.” Another patient said “sometimes a 10 minute appointment isn’t long enough to discuss your problem”.

The provider took adequate steps to ensure patients were protected against the risks of receiving care or treatment that was inappropriate or unsafe. There were suitable arrangements in place for all staff to be able to recognise and report safeguarding concerns to the relevant person and authority.

Patients were protected from the risk of infection because appropriate guidance had been followed. Patients told us they thought the surgery was clean and tidy. The provider had an effective system to regularly assess and monitor the quality of service that patients received. However, patients were not actively encouraged to comment about the services provided except for individual GPs.

The provider followed a recruitment process for staff before they were employed to work with vulnerable patients and were able to demonstrate full references were requested.