We carried out an announced comprehensive inspection at Drs Carr and Davies, known as the Crown Surgery on 3 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service 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 and good for all population groups.

We rated the practice as good for providing safe, effective, caring and responsive services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We rated the practice as requires improvement for providing well-led services because:

• The practice did not have clear and effective processes for managing risks, issues and performance.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance is in place in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Refine the complaints process.
• Review and update the cleaning schedule.
• Ensure the emergency equipment is easily accessible in the case of an emergency.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Bland Carr and Davies (also know as The Crown Surgery) on 13 June 2016. 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 the skills, knowledge and experience to deliver effective care and treatment but there were some gaps in training.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• A system should be in place to review the impact of any action taken in response to significant events.

• Repeat prescriptions that are dispensed by the surgery should be signed before medicines are given to patients.

• Where the decision has been made not to carry out a DBS check on staff, the practice should be able to give a clear rationale as to why.

• Regular fire drills should be performed.

• Improve the way in which patients who are carers are identified and recorded.

• Complete the outstanding staff training and appraisals and continue to review annually.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice