We carried out an announced comprehensive inspection at St Saviours Surgery on 5 March 2019 as part of our inspection programme.

At the last inspection in February 2016 we rated the practice as good overall.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and requires improvement for safe services. We have rated the practice as outstanding for providing caring services and for the population group of long term conditions. We have rated the practice as good for providing effective, responsive and well-led services:

We rated the practice as requires improvement for providing safe services because:

• There was an ineffective system in place to manage and monitor emergency medicines. We found that a number of emergency medicines were not held by the practice and no risk assessments had been completed to determine their rationale. In addition, some medicines were in the process of being ordered by the practice, however two of the recommended medicines were found to be out of date. On the day of our inspection, the practice took immediate action in relation to this finding to reduce any risks to patients.

We rated the practice as outstanding for providing caring services and for the population group of long term conditions because:

• The practice could evidence that all indicators for long term conditions were higher than the local and national averages with lower exception reporting rates than local and national averages. Evidence to support this demonstrated there was a sustained improvement in the diagnosis and management of long term conditions.

• All the practice’s indicators for diabetes were higher than local and national averages with overall low exception reporting rates. The practice had systems in place so that patients who were at risk of developing chronic diseases were coded on their system. For example, 468 patients had been coded who were at risk of developing diabetes.

• Patient feedback through comment cards, reviews on NHS Choices and patient consultations on the day of the inspection were very positive about the caring nature of the practice.
• Patient satisfaction through the National GP Patient Survey was higher than both the CCG and England averages across all indicators relating to caring.
• Feedback from patients told us that the practice gave consistently good care and used a variety of formats to engage with different population groups.
• The practice had proactively identified and supported 140 carers, approximately 3% of the practice population. Patients identified as carers were eligible for a number of services such as flu vaccinations, a carers card and a referral to The Carers Association. There was literature in the practice waiting room of local support groups and networks.

We

also rated the practice as good for providing, effective, responsive and well-led services because:

• Patients received effective care and treatment that met their needs.

• The practice worked proactively with other organisations to ensure patients had access to a range of services to support their health and wellbeing.
• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
• The practice worked proactively with the Patient Participation Group (PPG) to respond to patients’ needs.
• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients

(Please see the specific details and action required at the end of this report).

The areas where the provider should make improvements are:

• Ensure that staff remain up to date with training considered essential by the practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Saviours Surgery on 9 February 2016. Overall the practice is rated as good.

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

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding and these were consistently applied. The premises were clean and tidy.

• Systems were in place to ensure medicines including vaccines were appropriately stored and in date. The recruitment procedure in place ensured that patients were protected.

• Patients had their needs assessed in line with current guidance and the practice had a holistic approach to patient care. The practice promoted health education to empower patients to live healthier lives.

• Feedback from patients and observations throughout our inspection showed the staff were kind, caring and helpful. Patients we spoke with told us they received good standards of care.

• The practice had systems in place to respond to and act on patient complaints and feedback. Where necessary senior staff ensured that lessons were learnt to prevent similar situations.

• There were governance systems in place to monitor the safety and the quality of the service provided. The staff were motivated and worked well together as a team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice