Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bute House Surgery on 26 May 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 the skills, knowledge and experience to deliver effective care and treatment.
• The practice had safe and effective systems for the management and dispensing of medicines, which kept patients safe.
• 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.
• Patients said they found it easy to make an appointment with a named GP 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• As part of an over 75s initiative piloted at the practice, the practice employed two community health care assistants, who bridged the gap between clinical and social care. Older patients were identified in various ways from clinicians, reception staff, frailty measures and outside agencies who may be at risk of hospital admission. These patients were comprehensively assessed in their own homes for their social, physical and mental well-being. They were offered an over 75s health check and then their care was discussed at multi-disciplinary meetings to ensure appropriate services were provided.
• Patients’ emotional needs were seen as important as their physical needs. The practice could demonstrate caring and empathy toward patients in time of loss and bereavement. Staff told us that if families had suffered bereavement, their usual GP contacted them or sent them a sympathy card. This call was either followed by a patient consultation at a flexible time and location to meet the family’s needs and/or by giving them advice on how to find a support service. On the anniversary of the loss of the family member the practice sent a ‘thinking of you’ card to family members to express further sympathy and offer on-going support.
• Patient satisfaction with overall care received at the practice, quality of consultations at the practice and satisfaction with accessing primary care were the highest of all GP practices within the locality clinical commission group (CCG). Patient satisfactions within the CCG were above the national averages. Patients thought Bute House Surgery staff provided high quality compassionate care.
• The practice held daily weekday surgeries at Sherborne Girls School (a boarding independent school) to meet the particular challenges of teenage girls living away from home. The practice had engaged with teenage patients at the girls’ school through a cycle of three yearly surveys to capture the views of the cohort of youngsters regarding services and facilities. This led to reviewing the frequency of drop in sessions at the school.

The area where the provider should make improvements is:

• Review the monitoring of vaccine refrigerator temperatures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Patients’ privacy and dignity were maintained. We spoke with eight people who told us they felt their privacy was respected at the practice. People told us they were treated with dignity and that communication with the practice was good. One person told us, “The staff are very professional. The communication here is very good and personal.”

Patients told us that appointments were easily made and sufficient time was allocated discuss their health concerns with their GP or other healthcare professionals at the practice. One patient told us, “I don’t feel rushed during my consultations here.” Another patient said, “There is always sufficient time to talk here.”

The surgery had effective arrangements to ensure cleanliness. We found that the surgery was clean. One patient told us, “It’s always as you see it here today -spotless.”

The provider carried out checks to confirm staff suitability before they started work.

The provider regularly monitored the quality and safety of the service and made improvements when necessary.