This practice is rated as Good overall. (Previous rating 25/06/2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Oakwood Medical Centre as part of our inspection programme on 10 October 2018.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Clinicians we spoke with were passionate about providing person centred care.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice actively sought and reviewed patient feedback and made changes to the service to better meet the needs of patients.
• The most recent results from the GP national patient survey (August 2018) showed overall satisfaction with the service. However, feedback regarding being able to contact the surgery by telephone and satisfaction with appointments were lower than local and national averages. The practice had made changes to address these areas.
• There was an effective system for managing complaints.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice engaged with local community organisations and charities to support patients. They had embraced new technology to improve communications and provide additional support for patients.

We saw areas of outstanding practice:

GPs and the practice managers worked with external organisations such as The Vale Royal Clinical Commissioning Group (CCG) to develop services that would benefit their patients: -

• One of the GPs had a lead role in the Northwich Care Home Scheme in the previous 12 months. This involved revising the scheme, which included developing a new template to collect data, medication reviews, out of hours visits, mentoring care home staff and meeting with other practices in the local area. The practice arranged two information giving events which were attended by nursing home staff and staff from local GP practices.
• One of the practice managers was working alongside the CCG to improve training days for non-clinical staff. The practice had also helped to improve services across the CCG as one of the practice managers had provided information governance training to all staff within the Vale Royal CCG.

The practice also provided resources to patients to support them with their care:-

• The practice had produced its own information for patients including Makaton (a language system using signs and symbols to help people communicate) signs and booklets and a guide to mental health services and support in the area.
• Information awareness events were held. One had been held for all patients about diabetes and events held specifically for carers on rights and advocacy.
• The practice had provided an awareness event to reduce the anxiety of visiting a GP for children at a local school with a learning disability.
• The practice had in the last 12 months paid for a therapist to attend the practice and provide massages and relaxing treatments for carers

The areas where the provider should make improvements are:

• The system for placing alerts on all family members when a child is subject to a child safety concern should be monitored to ensure it continues to be effective.
• The Quality Outcome Framework indicators (QOF) should be closely monitored to ensure exception reporting is appropriate.
• Follow up consultations with patients diagnosed with cancer in the preceding 15 months should be monitored to ensure these occur within 6 months of diagnosis.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oakwood Medical Centre on 25 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, safe, effective, caring and responsive services. It was also good for providing services for all population groups it served.

Our key findings were as follows:

• The practice had clearly defined governance systems that promoted patient safety. One example was the way in which the practice recorded all patient interactions, requests, queries, messages and responses to these on the electronic patient record system, giving an auditable trail for review.
• Clinical audit drove improvement. All staff were engaged in continuous improvement through training. Both the practice manager and the patient services supervisor had studied Productive General Practice through the NHS Institute of Innovation and Improvement. Learning from this had been applied within the practice.
• The way in which the practice engaged with patients helped patients take ownership of their healthcare needs. Patients told us they received high quality care that was compassionate and met their needs.
• The practice was able to demonstrate that they were truly responsive to patients’ needs. Plans to host services in the practice reflected the demand for those services. For example, community mental health team services, counselling services.
• The practice was well-led. Leaders worked to analyse and forecast patient demand and contracted services accordingly. This included the use of an intermediary care bed service, where patients could receive support between leaving hospital and returning home. Figures showed this service was well-used helping prevent hospital admission and reducing the length of time a patient would typically spend on a hospital ward.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice