This practice is rated as Good overall. (Previous rating July 2016 – 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 Rookery Medical Partnership on 30 October 2018. We inspected the practice as part of our inspection programme.

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

• 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.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice’s performance on quality indicators was 100% which was above the Clinical Commissioning Group (CCG) and England averages with comparable exception reporting rates.
• The practice routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines. We saw evidence of audits that drove improvements throughout all levels of care.
• We found there were established safeguarding processes for all staff to follow. Staff were encouraged to report safeguarding concerns. The information was shared with other relevant agencies. The practice had appointed a clinical and non-clinical safeguarding lead and staff had received the appropriate training.
• Patients in care homes were visited weekly by the GPs to ensure they had continuity of care and to reduce admissions into accident and emergency.
• The practice was a teaching and training practice for medical students and qualified doctors training to become a general practitioner.
• The practice held weekly advanced wound care clinics to help those patients who found it difficult to get appointments with the community leg ulcer service. The clinic provided both wound care to tissue viability standard and the measurement of stockings, after care advice and tips on the prevention of further leg ulcers. This was a service that Rookery Medical Centre provided free of charge to the CCG. We saw positive feedback from patients regarding this service.
• The CCG pharmacist was an independent prescriber and attended the practice regularly. They carried out polypharmacy reviews on patients taking more than eight medicines. The aim was to stop unnecessary medicines and to reduce side effects. Patients could have an appointment with the GP afterwards for any further questions.

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 Rookery Medical Practice on 18 July 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.

• The practice used a range of assessments to manage the risks to patients; they were assessed and well managed.

• Practice 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 more difficult to make an appointment with a named GP, however, they found that the triage appointment system worked well. On the day of the inspection, we found this system was safe and effective, however we found there was scope to improve reviews of the system . Urgent appointments were 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.

• The practice had been accredited a Dementia Friendly practice 2016/2017 by the West Suffolk Clinical Commissioning Group.

• All staff had a good awareness of the needs of patients whose circumstances made the vulnerable. We saw numerous examples of the proactive and person centred approach for individual patients. The practice were proactive in identifying and providing additional support to patients and in working with other agencies. We saw how people had been supported to maintain their independence and to live at home and access community and voluntary services. This helped ensure their welfare.

The areas where the provider should make improvement are:

• Regularly review and audit the triage appointment system to monitor and ensure that the service continued to offer safe and high quality care.

• Proactively identify and offer support to carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection on 11 July 2013, we found the service to be welcoming with friendly staff. People who used the service told us they were happy with the appointment system. One person told us: “This is a very nice practice doing a job in difficult circumstances.” Another person told us: “The diabetic nurse is very good, very informative. Always happy for us to call if we have a problem.”

We saw that on arrival at the service people could speak to reception staff or use the touch in booking screen. People told us staff treated them respectfully and were helpful. We saw that staff spoke politely to people and consultations were carried out in private treatment rooms. One person told us: “The GPs are very good at asking lots of questions and explaining what they are doing, with tests and such. They explain exactly why they are doing them.”

Information was clearly displayed for people, including health promotion, access to support services and information about the practice and the services provided.

During our inspection we saw from the records we looked at that staff had received regular training, supervisions and appraisals. Appropriate pre-employment checks had been carried out.

The service had policies and procedures in place to deal appropriately with any issues that might be raised.The people we spoke with were happy with the service and did not have any concerns or issues about the care and treatment they received.