Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Blackmore Vale Partnership on 27 September 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 held monthly all staff meetings where discussion and shared learning on these events took place.
• Risks to patients were assessed and well managed throughout the practice.
• Responsive, innovative approaches to providing integrated person-centred pathways of care were evidenced by the practice employing a pharmacist and a pharmacy technician in order to reduce poly pharmacy in its large elderly population (polypharmacy is when patients are taking 10 or more medicines), in order to reduce the side effects of multiple medicines being used, reduce waste and support the management of multiple conditionsStaff 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. Staff training needs analysis had been undertaken and the results implemented.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. All of the feedback from patients and the patient participation group (PPG) was positive.
• Information about services and how to complain was available and easy to understand. The practice carried out an annual complaint audit, the findings of which influenced shared learning events and 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 had good facilities which were spacious and 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 practice had a large active patient participation group which carried out numerous health promotion events and activities in support of the work of the practice.
• The provider was aware of and complied with the requirements of the duty of candour.

We identified an area of outstanding practice:

• There was a range of easy to read communication leaflets and booklets at the practice. Practice staff had devised a series of 12 photographic images which explained the process of visiting the practice to receive a health check and blood test. This was aimed at the 100 patients registered with learning disabilities and had attracted positive feedback from these patients in providing reassurance and reducing anxiety prior to and during such visits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall.

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 The Blackmore Vale Partnership on 15 May 2018 as part of our inspection programme.

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.
• The practice used the Gold Standard Framework (GSF) for patients over 65 years to help identify and predict risks for older patients in primary care. Patients identified as living with severe frailty were also reviewed every month at multi-disciplinary meetings in order to co-ordinate care to meet individual needs.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice communicated changes to patients by providing information on the website, on social media, in the waiting room and in local press.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• There was an active patient participation group which had contributed to decisions regarding service improvements. This included the recruitment of staff, the development of a ‘self-guided health walks’ leaflet and the implementation of information screens and self-service water tanks in the patient waiting rooms.

The areas where the provider should make improvements are:

• Review systems to monitor the storage of medicines, including medicines that require refrigeration.
• Review arrangements for the use of Patient Group Directions (PGDs) by individual health professionals working under the direction, to include signatures to confirm how they are used.
• Provide Mental Capacity Act 2005 training for all relevant staff to enable staff to understand their responsibilities under the Act and comply with its codes of practice.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.