Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eyam Surgery on 16 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working aged people (including those recently retired and students), people whose circumstances make them vulnerable and people with mental health (including people with dementia)

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients and staff were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients said they were treated with empathy, compassion, dignity and respect and they were listened to and involved in making decisions about their care and treatment.
• Information about services and how to complain was available and easy to understand. Complaints were investigated and responded to in a timely and appropriate way.
• 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. Referrals to secondary care services were made appropriately and in a timely manner in line with local and national guidance and targets.
• 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 passionate and proud of the work they did and the treatment that patients received. Staff were supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that all staff undertake role specific training in safeguarding vulnerable adults and children.
• Implement a more robust system for tracking blank prescriptions to minimise risks of misuse or error and to promote robust monitoring of these.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

We spoke with six patients of Eyam Surgery during our inspection. We did this to help us to understand the outcomes and experiences of patients who used the practice. Patients told us that all of the staff at the practice treated them with respect and the GP’s and nurses were friendly and approachable. Their comments included; “All of the Doctors are very friendly, but thorough” and, “I’ve been supported to access lots of other services through the practice, they’ve been very helpful.”

We found that patients were involved in their care and treatment which was provided in a way intended to ensure their safety and welfare. There was a dispensary service at the practice and we received positive feedback from patients about the service.

Patients were being cared for in a clean, hygienic environment. However we found that patients and staff were not always protected from the risk of infection because appropriate guidance had not been followed.

We found that the provider could not be assured that patients were being cared for, or supported by, suitably qualified, skilled and experienced staff. This was because there were ineffective recruitment and selection procedures in place.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. However we found there were ineffective systems in place to identify, assess and manage the risks to the health, safety and welfare of patients and others.

On this occasion, we did not speak with any people using the service due to the nature of the standards we inspected.

We found that most of the required improvements had been made since our previous inspection in December 2013.

The practice was visibly clean and hygienic, and effective systems were in place to protect patients and staff against the risk of infection.

The practice’s policies and risk assessments had been reviewed to ensure these were up-to-date and accurate. Where risks were highlighted measures had been put in place to minimise the risks.

Regular fire drills were carried out to ensure that people knew how to evacuate the premises safely. Records also showed that all staff had attended recent fire awareness training to ensure they had an adequate knowledge of fire safety, and knew the procedure to follow in the event of a fire.

Robust recruitment procedures were not always followed, to ensure that the required information was available in respect of all staff to ensure they are suitable to carry out the work. We received assurances following the inspection that the recruitment procedures had been strengthened.