Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 12 January 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Mill Road Surgery on 12 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk and safety incidents to ensure they were less likely to happen.
• The practice learned from incidents and improved their processes, this was seen in meeting minutes and action plans.
• The practice routinely reviewed the effectiveness and appropriateness of the patient care they provided.
• Care and treatment was delivered according to evidence-based best-practice guidelines.
• Staff employed to dispense medicines had received regular checks of their competency to dispense medicines.
• All staff received an appraisal annually.
• Staff treated patients with compassion, kindness, dignity and respect.
• Patients told us they were involved in their care and treatment decisions.
• The practice responded to current patient needs and had developed forward planning to meet their recent patient population growth.
• We saw a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice maintained a registered list of people that were either isolated or alone during the Christmas period. During the week leading up to Christmas, they personally delivered a hamper to each person on the list to show the practice cared and was thinking of these people during the holiday period.

The area where the provider should make improvements are:

• Improve the identification and recording of carers registered at the practice to ensure they are offered the required support and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mill Road Surgery on 12 January 2016. Overall the practice is rated as good.

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

• Staff knew how to raise concerns, and report safety incidents. Safety information was recorded, monitored, and reviewed to identify trends or recurrent themes. When safety events occurred they investigated the issues and shared any learning with all staff members.

• Risks to patients were well managed; the system for assessing risks included those associated with medicines, premises, equipment and infection control.

• Patient care was planned and provided to reflect best practice and recommended current clinical guidance.

• Staff had received appropriate training for their roles and further training had been encouraged, recognised and planned.

• Information regarding how to complain was available in a leaflet and on the practice website, this was easy to understand and comprehensive.

• The practice staff members had received training about safeguarding children and vulnerable adults, and knew who to contact with any concerns.

• The practice was adequately equipped to treat patients and meet their needs. The equipment had been checked and maintained to ensure it was safe to use.

• Patient comments were positive when we spoke to them during the inspection.

• The leadership structure at the practice was well-established and all the staff members we spoke with said they felt supported in their working roles by both the practice manager and the GPs.

We saw an area of outstanding practice:

• The practice maintained a list of people registered with the practice that were either isolated or alone during the Christmas period, and delivered a hamper to them to show that people cared during the holiday period.

The areas where the provider should make improvement are:

• Provide staff members that are employed to dispense medicines a regular appraisal, and check their competency to dispense medicines on a regular basis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Mill Road Surgery provides primary medical services for approximately 12,000 patients living in Colchester and the surrounding area, with the capacity to take 16,000 patients. The practice provides a pharmacy dispensing service. The practice was established as a GP and nursing training practice. The practice has not recently provided training to GP registrars, but is looking to resume this in the future. GP Registrars are fully qualified doctors who are training to specialise in General Practice.

We found from our inspection that generally patients were satisfied with the service provided to them at Mill Road Surgery. Patients mostly found that clinical and reception staff were pleasant and any issues were dealt with in a timely manner. Most people told us that they were treated with dignity and respect; the GPs requested consent appropriately and discussed any treatment options available.

We found the practice to be responsive to the changing needs of their patient population and proactive in putting plans in place for future changes.

There were systems in place for dealing with non-clinical emergencies.

Although the practice checked emergency medicines were available we found some were out of date. There were no formally documented checks to ensure that the emergency equipment was working. We also found that the systems within the practice for checking fridge temperatures were inadequate; although the systems in place in the dispensary for the same activity were robust.

There was an open culture within the practice which encouraged staff and patients to report incidents and concerns, and to suggest improvements. The GP partners and practice manager had a clear vision of the practice’s principles and priorities.

The practice used clinical audits and dispensary audits, as well as best practice, to improve the outcomes for all patients.