Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Male and Partners – Thornbury Health Centre on 12 April 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.
• Risks to patients were assessed and well managed.
• 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 easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice provided minor injuries clinics for cuts, lacerations, minor fractures and injuries.
• The practice leased their accommodation which was managed by their landlord and so had limited opportunity to make changes. However, they had good facilities and were 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 areas where the provider should make improvement are:

• All pre-employment checks should be fully recorded.

• The system for checking emergency equipment should be failsafe and monitored.

• The practice should ensure treatment and consulting rooms are locked when unoccupied.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Dr Male and Partners based at Thornbury Health Centre is a semi-rural practice which provides primary care services to patients living in Thornbury, South Gloucestershire and surrounding areas, Monday to Friday during working hours. In addition there are a range of clinics for all age groups and specialist nursing treatment and support.

As part of our inspection we spoke with other organisations, such as; the South Gloucestershire Clinical Commissioning Group, the local Healthwatch and other healthcare providers to share what they knew. We talked with patients and staff.

The practice used a range of information to identify risks and improve quality regarding patient safety. They had a system for reporting, recording and monitoring significant events. Patients were protected from the risk of abuse. The practice had systems which recognised and supported patients who were at risk of abuse. Patients were treated by suitably qualified staff. Patients were cared for in a safe environment. The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies. The practice was well maintained. Patients were protected from the risks of unsafe medicine management procedures. Patients were cared for in an environment which was clean and reflected good infection control practices.

The practice met nationally recognised quality standards (the Quality and Outcomes Framework - QOF) for improving patient care and maintaining quality. For example, the management of patients with long term conditions comparing favourably with other practices in the area. Patient care was improved by the regular monitoring of treatment. Patients’ rights were protected with regards to the consent process. Patients' care was managed by the practice and other healthcare professionals. The practice worked with other primary care providers to co-ordinate care. The practice had opted out of providing out of hours care. This was provided by another Out of Hours provider.  Patients had access to a range of health promotion information to improve their health.

Patients we spoke with were very satisfied with their care and treatment. This was confirmed by results from the GP patient survey which demonstrated 98% of respondents from the practice had confidence and trust in their GP. Patient privacy was respected and they were involved in their treatment decisions.

Patients were generally able to get an appointment when they needed it. However. there were areas for minor change for example, appointments running late. The practice had taken steps to address the issues. Patients with disabilities had the support and resources to promote independence.

Patients were cared for by staff who were aware of their roles and responsibilities for managing risk and improving quality. Staff told us they worked well as a team and were well supported to undertake their role. GPs and nurses were encouraged to update and develop their clinical knowledge and skills. The practice used a range of approaches to collect patient feedback. Patients' views on the service were listened to.

The practice supported older patients and patients with long term conditions by offering advice and support through specialist clinics, screening and evidence based information. The practice supported mothers, children and young people by working with other healthcare providers. The practice supported the working age population and those recently retired by offering a flexible appointment system. The practice supported patients in vulnerable circumstances by the early identification and protection of patients at risk. The practice supported patients experiencing poor mental health by regular monitoring of their treatment and support needs.

Please note that when referring to information throughout this report, this relates to the most recent information available to the Care quality Commission (CQC) at that time.

We reviewed the information available to us about Streamside Surgery - Thornbury Health Centre on 7 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.