Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

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 – Good

People with long-term conditions – Good

Families, children and young people – Good

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

People whose circumstances may make them vulnerable – Good

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

We carried out an announced comprehensive inspection at The Island Surgery on 13 December 2017. We carried out a comprehensive inspection of this service 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 is 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:

• 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.
• National data showed that the practice was performing below national averages for mental health related indicators. We spoke to the practice and they said this was due to a computer system error. When we reviewed patient records we found there had been appropriate clinical care and reviews documented.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Staff had received mandatory training applicable to their role.
• There was sufficient and appropriate equipment for use in the treatment of patients, including in the event of a medical emergency and the equipment was calibrated to ensure it was working correctly.
• There was a lack of documentation when cold chain procedures had not been followed. However we spoke with staff and they were aware of how to handle medicines in such circumstances.
• The practice was clean and tidy and staff had reviewed infection prevention control and policies.
• The practice was aware of their patient population needs and their preferences and worked to accommodate them.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Leadership of the practice was strong and the whole staff group worked as a team, with members’ skills complimenting each other. Patients spoke highly of the care they had received from the entire team at the surgery.
• The practice had identified a high number of patients who were carers. They were offered support and provided with advice and guidance.

The areas where the provider should make improvements are:

• Strengthen documentation of actions taken when cold chain procedures are not being followed. Implement a method to monitor room temperatures for medicines stored outside of fridges.
• Ensure there is an effective system to review medicine safety alerts for newly registered patients.
• Improve coding practice to ensure patient consultations are correctly captured for mental health patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice