Letter from the Chief Inspector of General Practice

This practice is rated as outstanding overall. (At the previous inspection undertaken in November 2015, the practice received a good overall rating)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Outstanding

People with long-term conditions – Outstanding

Families, children and young people – Outstanding

Working age people (including those recently retired and students – Outstanding

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people with dementia) - Outstanding

We carried out an announced comprehensive inspection at The Golden Brook Practice on 20 November 2017. This inspection was carried out 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:

• Audit and improvement was at the heart of the practice and developing the care delivered to patients in a collaborative and supportive manner was the aim of all members of staff.
• Staff worked closely with community teams and we observed that the relationship with social care was driving responsive and compassionate care for patients, including keeping those at risk from harm safe.
• Results from the latest national GP patient survey showed that the practice had performed above local and national averages in the majority of the questions about patient experience. This was particularly evident in relation to GP and nurse access and comments regarding being cared for in a dignified and respectful manner.
• Patient feedback was held in high regard with development and trials conducted to improve the service based on the views of patients, staff and stakeholders.
• The practice had a consistently high Quality and Outcomes Framework (QOF) achievement and offered annual reviews to patients whose conditions were not included in the Quality and Outcomes Framework to ensure their condition was monitored.
• The practice encouraged and supported staff to report incidents and near misses. When incidents did happen, the practice learned from them and improved their processes. Staff were all invited to review meetings and outcomes disseminated to all staff.
• We saw several examples where staff had gone the extra mile and patients praised staff for providing care in a supportive and compassionate manner.
• 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.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff training records were up to date, and regular appraisals encouraged development at all levels.
• An online enquiry form for non-urgent consultations was developed, to allow for convenient access to GPs for queries outside working hours.
• There was strong clinical leadership and we saw how this positively influenced the quality of the service. For example, the GP prescribing lead had overseen cost effective prescribing, and lower rates of antimicrobial prescribing in line with evidence-based guidance.
• The partners invested high levels of time and funding in their practice team to provide sufficient capacity, and ensure there was adequate numbers of staff in both clinical and administrative role to allow for effective delivery of care.

We saw an area of outstanding practice:

• The leadership and culture of this practice was one of continuous development with all staff having accountability and drive to deliver change and provide care in an effective and supportive manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Golden Brook Practice on 3 November 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had arrangements in place to deal with information about safety. Staff were aware of their responsibility to report incidents and concerns and knew how to do this. Information relating to safety was documented, monitored and reviewed
• Risks to patients were assessed and well managed; although the practice needed to ensure they had oversight of all measures in place to mitigate risks related to the environment and premises.
• Staff used best practice guidance to assess patients’ needs and plan their care. Staff had received relevant role specific training and further training needs were identified for staff through appraisal.
• Patients told us staff treated them with compassion, dignity and respect and involved them in decisions about their care
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day.
• 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 practice proactively sought feedback from staff and patients, which it acted on.

However there were some areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure comprehensive arrangements are in place to identity, assess and manage all risks associated with premises including infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice