Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fernlea Surgery on 20 July 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 had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• 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:

• To continue to look at ways of improving cervical screening uptake at the practice.
• To review the National GP Patient Survey results to identify how the practice can improve patient satisfaction scores which are below local and national averages.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our last inspection on 31 December 2013 we noted that the provider had not taken reasonable steps to identify the possibility of abuse and prevent it from happening. All staff had received child protection training, however most staff had not received training in the safeguarding of vulnerable adults. The practice’s policies such as safeguarding vulnerable adults and the whistleblowing policy also required updating with contact details of external organisations for staff to approach.

At this inspection we found that the provider had taken action to ensure that most staff had received training in the safeguarding of vulnerable adults, and that the policies for safeguarding vulnerable adults and whistleblowing had been updated.

During our inspection the practice had developed a water leak in one consulting room and a corridor. The practice had dealt with the unforeseen emergency by alerting the landlords to the emergency, monitoring the area and taking action to ensure patients were notified of the situation and seen in an alternative room.

People who use the service were given appropriate information and support regarding their care or treatment. One person told us “Yes, they explain everything. I had a back problem and the doctor gave me leaflets explaining the main cause of the pain”. The patients we spoke to on the day of the inspection told us they were happy with their care and treatment. They told us it was sometimes difficult to get through on the telephone to make an appointment, but once they arrived at the surgery they did not usually have to wait long to be seen.

People who use the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and reduce the risk of it happening. All staff had received training in child safeguarding. However some staff had not carried out vulnerable adult safeguarding which meant their understanding of the issues about this was limited.

Staff received appropriate professional development. Staff told us they felt supported and encouraged to do further training. We reviewed five staff records which showed that staff had undergone formal training in courses such as customer care and learning disability in 2013.

There was an effective complaints system available. We reviewed four recent complaints and found they had been investigated and responded to appropriately.