Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newhall Surgery on 10 February 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. All meetings across all staff groups included significant events as a standard agenda item.
• There were comprehensive risk assessments undertaken and regularly reviewed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Personal development was encouraged and provision made regularly for this for all staff via the appraisal process.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients were routinely given the opportunity to assist in writing their own care plan.
• Information about services and how to complain was available and easy to understand.
• Feedback from patients about their care was consistently and strongly positive and they were always able to see a GP or nurse on the day they called.
• The practice had good facilities and was well equipped to treat patients and meet their needs. This included baby changing facilities and treatment rooms which had been purposefully refurbished.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example: equipment had been purchased following fundraising activities, events to raise awareness of health issues were conducted regularly, ‘Teddy bear’ clinics had been introduced to reduce anxiety for children receiving immunisations.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was reviewed and discussed with staff.

We saw two areas of outstanding practice

• The practice had introduced innovative ways of engaging children within the practice for example; the Teddy Bear clinics which enabled an attendance rate of 98%-100%.
• The practice proactively monitored and managed all patient falls that were reported. This had resulted in the number of emergency hospital admissions for over 65s being around 250 per 1,000 people which is substantially lower than the CCG and locality averages (CCG was around 285 and locality average was around 295).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out this inspection to see if the provider had made improvements to safeguarding procedures and recruitment practices following our last inspection in August 2013.

At the time of our last inspection, people told us they were happy with the care they received and felt safe at Newhall Surgery. During this inspection we found people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

At our last inspection we identified a concern that appropriate background checks had not been completed for all staff prior to employment at Newhall Surgery. People that we spoke with did not express an opinion about this subject. During this inspection we saw that the provider had developed a robust recruitment policy and appropriate checks were present for all staff.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

Patients told us they felt they were treated with dignity and respect. One patient told us “I’m satisfied with the service I receive.” Another said “Staff are friendly and welcoming.” Patients told us sometimes they could overhear other patients discussing health issues at reception. However, they knew they could request a private consultation with reception staff. No one spoken with expressed any concerns about booking an appointment, or about how long they waited to be seen once they had arrived at the practice. Several patients told us they disliked discussing their symptoms with reception staff, even though the information was used to assist with allocation of appointments.

Patients said they felt involved in their care and were able to ask questions. They said treatment options were discussed with them, and results of tests were fully explained. We saw patients had access to a range of written information about medical conditions.

We saw there were robust systems in place for safeguarding children, but the arrangements for safeguarding adults were less robust. However, staff had a good understanding of safeguarding issues and how to recognise and respond to signs of abuse or neglect.

Risk assessments had not been completed for staff who had been employed prior the current recruitment checks being in place.

Patients were asked their views about their care and treatment and these were acted upon. Patients knew how to raise any complaints.