Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Middle Chare Surgery on 26 April 2016. Middle Chare Surgery is part of one large provider (Middle Chare Medical Group) who have four locations. All patients can be seen at any of the locations; however, most attend one of two for continuity of their care. Patients attending Middle Chare Surgery also attend Woodlands Surgery. 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.
• Patients said they found it easy to make an appointment, although not always with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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 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. They encouraged a culture of openness and honesty.

We saw areas of outstanding practice:

The practice worked in collaboration with the Ear Nose and Throat department from the local hospital and provided a room for consultations. This collaborative way of working had led to improved knowledge in this area and had reduced practice referrals to secondary care, providing care closer to home.

The practice provided a dermoscopy service to its patients and this had led to a reduction in referrals to secondary care.

The areas where the provider should make improvement are:

To monitor that all staff are able to access policies and procedures.

To monitor clinical audit as a continuous process to demonstrate quality improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The reason for this visit was to check if improvements had been made in the area of medication management and storage following a previous inspection.

We saw the provider had effective systems in place to manage medicines. We found medicines at the practice were being managed and stored effectively.

People we spoke to were positive about the care they received at the practice. Comments included, “I have been a patient here all of my life and I called this morning for an appointment. I can usually get an appointment the same day" and “The doctors and nurses give you time, listen, and explain things in terms that can be understood”.

We found people were given the information they needed to make an informed decision about their care.

We saw people were cared for well and care was planned for the individual.

People were protected from the risk of infection as the provider had a system in place to ensure their safety.

We found medicines at the practice were not being managed or stored effectively.

We saw there was a recruitment system in place and the correct checks were made before staff started work at the practice.

The provider had a system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.