Letter from the Chief Inspector of General Practice

Standish Medical Practice was inspected on the 18 November 2014. This was a comprehensive inspection.

We rated Standish Medical Practice as good in relation to being safe, effective, caring, responsive and well-led.

Our key findings were as follows:

The practice had systems in place to ensure best practice was followed. This was to ensure that people’s care, treatment and support achieved good outcomes and was based on the best available evidence.

Information we received from patients reflected that practice staff interacted with them in a positive and empathetic way. They said that were treated with respect, in a polite manner and as individuals.

A system was in place to ensure the practice was regularly cleaned. We found the practice to be clean at the time of our visit. A system was in place for managing Infection prevention and control.

Patients had good access to medical care and we were assured that if a patient needed to be seen they could access a GP appointment on the same day. To improve patient access an open surgery was provided each day between 815am and 1015am where patients were able to see one of five GPs without an appointment. Afternoon GP surgeries were also provided by appointment. A late GP surgery was provided on Tuesday evenings. This was particularly helpful to patients who worked. Consultations with the practice nurses were by appointment.

We saw areas of outstanding practice including;

We looked at records relating to how the practice team learnt from incidents and subsequently improved safety standards. The examples we looked at showed how incidents were investigated by defining the issue clearly and identifying what actions needed to be taken to address the risk and minimise or prevent it from happening again. One of the examples we looked at highlighted a clinical issue which resulted in action being taken to improve safety for patients at the practice and within the Wigan area. This had been achieved by the practice working closely with colleagues in the wider health community to bring about the improvements.

In addition the provider should:

Clinical staff we spoke with clearly understood the importance of obtaining consent from patients and of supporting those who did not have the mental capacity to make a decision in relation to their care and treatment. However staff training records and discussion with staff reflected that they had not been provided with any formal training in respect of the Mental Capacity Act 2005. The provider should ensure relevant staff are enabled to access such training to maximise their effectiveness in supporting patients who do not have the mental capacity to make a decision in relation to their care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 18 November 2014 – Good)

The key questions 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 Standish Medical Practice on 6 June 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 is 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 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Patient feedback on the care and treatment delivered by all staff was consistently positive.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice, through the patient participation group (PPG), worked in collaboration with local schools to produce posters and leaflets for the local population. These were distributed across Standish and were for patients to update their contact details with the practice. They also asked if patients were carers and also if they would like to know more about the PPG. This initiative had enabled the practice to engage with those members of the patient population who had not updated their contact details with the practice.

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