Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marlborough Medical Practice on 12 December 2016. Overall the practice is rated as good.

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

• There was a clear leadership structure and staff felt supported by the partners and the management team. The practice proactively looked for improvements and acted on staff recommendations. We saw a high level of staff satisfaction and very good staff retention rate. Staff told us they were proud of the practice as a place to work. The practice also had an active patient participation group who were very engaged in the practice and supporting improvements for patients.

• There was an open positive learning culture in the practice and a transparent approach to safety with an effective system in place for reporting and recording significant events. The practice valued opportunities to learn from any events, near misses or suggestions.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice staff we spoke to recognised that patient care was central to the ethos of the practice and told us the practice treated patients as individuals and was proactive in considering their needs and expectations.
• The practice had taken a number of measures to engage with the local community and had been liaising with the local town council, local members of parliament and local patient representatives to promote their services explain their challenges and help meet the patient expectation and use the information sharing to help tailor and improve services.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure that the governance around Controlled Drugs is improved in order to accurately record running balances; record patient returned medicines and improve the security of the key to the CD cupboard.

• Review the location of the defibrilator.

• Ensure that all prescriptions for repeat medicines are signed by a prescriber before the medicines are supplied to a patient.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our visit to Marlborough Medical Practice we met and talked with patients, three GPs, the practice manager, five practice nurses, a healthcare assistant, practice dispensary staff and administration staff. The patients we met with were generally happy with the service they received. Comments we received from patients who were at the surgery when we visited included: "the practice is fine" and "I think it's really good." One patient said: "when they put their mind to it they do really have some great personal touches." Another patient said: "I would definitely recommend them. I feel heard when I come here."

We found the practice respected the dignity, privacy and independence of people they looked after. People were able to make decisions about their treatment. They were treated with consideration and respect. Staff would respond appropriately to any allegation or suspicion of abuse of a vulnerable person, although training had not been sufficient in the area of vulnerable adults.

The medical staff made sure people were referred safely into the care of other health and social care professionals and care was coordinated. Staff were trained and supported to carry out their roles and responsibilities. The provider regularly assessed and monitored the service it provided to ensure it delivered safe quality care and treatment, although it needed to improve the way it worked with people to hear their views and experiences.