This practice is rated as Requires Improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at St Werburgh Medical Practice on 20 November 2018 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had systems, processes and practices to help keep people safe and safeguarded from abuse.
• Staff had the information they needed to deliver safe care and treatment to patients.
• The arrangements for managing medicines in the practice did not always keep patients safe.
• The practice learned and made improvements when things went wrong.
• Performance for one of the diabetes related indicators for 2017 / 2018 was below local and national averages.
• Exception reporting for some QOF indicators relating to patients with long-term conditions and people experiencing poor mental health was much higher than local and national averages.
• Not all staff had received an appraisal within the last 12 months.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was in line with local and national averages. However, we received seven comments cards that indicated patients were not always able to book a routine appointment at a time that suited their needs.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• Governance arrangements were not always effective.
• The practice’s processes for managing risks, issues and performance were not always effective.
• The practice involved patients, the public, staff and external partners to support high-quality sustainable services.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

The areas where the provider should make improvements are:

• Continue to implement and monitor the effectiveness of fire safety and legionella management action plans to reduce identified risks.
• Continue with planned basic life support training for the member of staff who was not up to date.
• Consider revising the appointments system to increase availability to further meet patients’ needs.
• Continue with plans to set up a patient participation group.

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.