Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Farrier House Surgery on 13 June 2017. The practice is rated as requires improvement for providing effective services. The overall rating for this practice is good.

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

• The practice was aware of and provided services according to the needs of their patient population. Staff received regular training and skill updates to ensure they had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Risks to patients were assessed and well managed.
• There were processes and procedures to keep patients safe. These included a system for reporting and recording significant events, keeping these under review and sharing learning where this occurred.
• The practice was aware of the requirements of the duty of candour and systems ensured compliance with this.
• Regular meetings and discussions were held with staff and multi-disciplinary teams to ensure that patients received the best care and treatment in a coordinated way.
• Patients told us they were treated with dignity and respect and that they were fully involved in decisions about their care and treatment.
• Action had been taken to respond to patient feedback results which were below local and national averages to ensure improvements continued to be made.
• Data showed that results for national screening programmes for breast and bowel cancer were below local and national averages.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Although the practice maintained a carers register work was in progress to identify more patients and ensure appropriate support was provided.
• There was a clear leadership structure which encouraged a culture of openness and accountability. Staff told us they felt supported by management.
• The practice had monitored and identified areas for improvement through their quality performance data.
• Information about services and how to complain was available and patients told us that they knew how to complain if they needed to.
• There was a strong focus on continuous learning and improvement at all levels.

We saw an area of outstanding practice:

• Outreach services for homeless people within the city of Worcester had been initiated by the practice. They had established regular clinics at a local day centre in order to promote health and wellbeing, providing appropriate healthcare and treatment where required. Length of appointments were not restrictive so that patients could be fully assessed and treated.

The areas where the provider should make improvements are:

• Continue the work already in progress to identify more patients who were carers and provide appropriate support.
• Ensure that action taken to address patient feedback continues to be monitored and reviewed.
• Continue with work already in progress to monitor areas of Quality Outcome Framework (QOF) where this is lower than average to identify areas for improvements.
• Continue to encourage patients to take part in national screening programmes for breast and bowel cancer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Farrier House Surgery on 13 June 2017. The overall rating for the practice was good. The practice was found to be requires improvement in providing a caring service and in providing effective services for the population group of working age people (including those recently retired and students). The full comprehensive report on the September 2017 inspection can be found by selecting the ‘all reports’ link for Farrier House Surgery on our website at www.cqc.org.uk.

This inspection was an announced desk top review carried out on 31July 2018 to confirm that the practice had carried out their plan to make the improvements that we identified in our previous inspection in June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had continued the work already in progress to identify more patients who were carers and provide appropriate support.
• Action taken to address patient feedback had continued to be monitored and reviewed.
• Monitoring had continued to be carried out in areas of Quality Outcome Framework (QOF) where results were lower than average to identify areas for improvements. Action had been taken to ensure coding was accurate and that patient registers were correct so that patients were monitored on a regular basis.
• Patients continued to be encouraged to take part in national screening programmes for breast and bowel cancer.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice