Letter from the Chief Inspector of General Practice

We inspected this service on 28 November 2014 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.
• There were systems in place to keep patients safe from the risk and spread of infection.
• Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. Information showed that the GPs were good at listening to patients and gave them enough time.
• The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

We saw areas of outstanding practice including:

• Two GPs at the practice provided specialist support for patients with mental health conditions. GPs told us they held weekly mental health clinics and drug and alcohol recovery clinics, but often met the needs of these patients outside these clinic times. We saw a comment from a patient who had experienced mental health problems. They had appreciated the support the practice had given them when they felt there had been no one else there for them.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Review their recruitment policy and procedures to ensure that all checks according to Schedule III of the Health and Social Care Act 2008 are carried out when staff are recruited.
• Establish a system to ensure that minutes of all meetings accurately record discussions that take place to provide an audit trail of information sharing, learning and outcomes.
• Establish a system to ensure that details of all clinical audits carried out by GPs are shared routinely. This would ensure best practise, knowledge and awareness is disseminated throughout the practice in a formal way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with nine patients and six members of staff.

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. A patient said: "I think it is very good at this surgery. The ladies on the desk are very good at relaying information".

The patients we spoke with provided positive feedback about their care. A patient told us: "It is very good. It's always quick to get an appointment and the treatment is always good. Excellent care". Patients who received regular medicines told us they were regularly reviewed to check that they still needed them.

Staff had received training in safeguarding children and vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from harm.

We found that staff had received appropriate training for the roles they carried out. They also had annual appraisals. This meant that they had been adequately assessed as being competent.

The provider had systems in place for monitoring the quality of service provision. There was an established system to regularly obtain opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.