Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The County Practice on 17 January 2017. 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. Lessons were shared to make sure action was taken to improve safety in the practice.

• 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.

• Patient survey figures showed patients rated the practice higher than others for most aspects of care. Comments about the practice and staff were positive.

• 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.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure and staff felt supported by management.

• The provider was aware of and complied with the requirements of the duty of candour.

• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons.

• The practice had a number of policies and procedures to govern activity and held regular meetings. However the practice did not always update action plans and documents such as risk assessments to say they had been completed.

• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

• The practice had identified 70 patients as carers (0.6% of the practice list).

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.

• Update action plans accordingly to evidence completed actions

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with ten patients on the day. One person said, “(I have) absolutely no problems to get appointments. If you’re really poorly, you can call in and wait to be seen.” Another went on to say, “It’s fantastic here. The doctors and nurses are very good and caring.” Another person we spoke with who was slightly less able said, “The doctor or nurse will often come out to help me to the room, which is really kind of them.”

We saw a well maintained and purpose built environment.

We saw the Patient Participation Group (PPG) were involved with the practice staff and participated in the annual patient surveys. That resulted in equipment being provided for the practice and the adjustment of internal doors throughout the practice being propped open, to assist less mobile clients.

We saw the appropriate checks were undertaken before staff began work.

We found patients felt confident to complain but all those we spoke with said there was nothing to complain about. Patients said if they did have a complaint, they would first speak with the receptionist or the doctor. Most patients were unaware of the patient survey although acknowledged there was a box in reception for patient feedback and suggestions.