We carried out an announced comprehensive inspection at Ludham and Stalham Green Surgeries on 10 January 2017. Overall the practice is rated as outstanding.

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. Where relevant, information was also shared with other practices in the area via a practice manager’s forum, upon instigation of the practice manager.
• 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.
• Feedback from patients about their care was positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice higher than others for most aspects of care.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The provider was aware of and complied with the requirements of the duty of candour.
• There was a clear leadership structure and staff felt well supported by management.

The area where the provider should make an improvement is:

• Ensure that the procedures following uncollected medicines and for dispensing high risk medicines is consistent across both dispensaries.

We saw various elements of outstanding practice:

• There were various means through which the management team had gone the extra mile to support staff and patients. For example, the practice manager had made various visits to staff that had been sick long term. There were arrangements in place for those members of staff that lived alone to ensure they arrived home safely if they were the last to leave the premises. Individual stress assessments had been undertaken with staff, who had also attended a stress management workshop in November 2015. In addition, the practice had been awarded the Royal College of General Practitioners (RCGP) East Anglia Faculty Practice Team Award in October 2016.
• The practice hosted the Alzheimer’s Society Dementia Café on a monthly basis. This was done during practice closure afternoons so that patients making use of this facility would experience the privacy they may wish for or require. 

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice