This practice is rated as Good overall.

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

We carried out an announced comprehensive inspection at Crosby Village Surgery on 13 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk and to ensure that safety incidents were less likely to happen. When safety incidents did happen, the practice learned from them and improved their processes.
• There were systems in place to reduce risks to patient safety. A risk register was in place and this was monitored.
• Procedures to prevent the spread of infection were in place and regular Infection control and cleanliness audits were carried out.
• Systems were in place to deal with medical emergencies and staff were trained in basic life support.
• Clinicians assessed patients’ needs and delivered care in line with current evidence based guidance.
• Systems to review the effectiveness and appropriateness of the care provided were in place and being developed further.
• Clinical audits were carried out and the results of these were used to improve outcomes for patients.
• Data showed that outcomes for patients at this practice were not always comparable to outcomes for patients locally and nationally. The provider was aware of the areas for improvement and was working on these.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff told us they felt supported in their roles and with their professional development.
• Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.
• The provider learnt from complaints and made improvements to the service as a result.
• There was a clear leadership and staff structure and staff understood their roles and responsibilities.
• The provider had a clear vision to provide a safe, good quality service.
• Systems were in place to check on the quality of the service.
• There were systems in place for clinical governance and these were being further developed.

The areas where the provider should make improvements are:

• Review the newly introduced governance systems to ensure these are effective in monitoring the quality of the service provided and drive improvement.
• Review the fire risk assessment and take action to mitigate risks associated with the rear fire exit.
• Risk assess and take action to mitigate risks associated with the door located on the staircase.
• Ensure all incidents are reported in a timely manner so that learning can be shared to improve outcomes for patients.
• Review the management of uncollected prescriptions.
• Review the provision of services and facilities to improve patient experience.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice