This practice is rated as Good overall. (Previous inspection October 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

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 Lakenham Surgery on 22 February 2018.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes. The practice shared outcomes of significant events with staff and other local GP practices.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment were delivered according to evidence based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff were consistent and proactive in helping patients to live healthier lives.
• The facilities and premises were appropriate for the services delivered.
• QOF performance for 2016/17 for diabetes related indicators was 85%; this was below the CCG average of 93% and below the England average of 91%.
• Annual health assessments for people with a learning disability were undertaken but required improvement. The practice had 79 patients on the learning disabilities register, of which only 3 had received a health review in 2017/18 at the time of inspection.
• There was a system for receiving and acting on safety alerts. For example, Medicines and Healthcare Products Regulatory Agency (MHRA) alerts were reviewed by the practice management team and GPs. Actions as a result were recorded but there was no log kept of historical responses. The practice informed us they would commence this immediately.
• Staff had the skills, knowledge and experience to carry out their roles and there was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice performed consistently above average for its satisfaction scores in the national GP patient survey. Patients responded positively to questions about their involvement in planning and making decisions about their care and treatment and felt they were treated with compassion, dignity and respect.
• Staff we spoke with told us they were able to raise concerns and were encouraged to do so. They had confidence that these concerns would be addressed.
• The practice had a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients.

The areas where the provider should make improvements are:

• Ensure QOF performance for diabetes and asthma achieves a good standard.
• Ensure annual health assessments for patients with learning disabilities are undertaken.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lakenham Surgery on 4 August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and managed; the practice was in the process of developing health and safety risk assessments and audits.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. However patients with a learning disability had not received annual health reviews.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients could speak on the telephone and make an appointment with a named GP. The practice provided selected alternate Saturday morning appointments with GPs, nurses and healthcare assistants. Routine as well as urgent appointments were available on the same day.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned. The practice valued the importance of quality, improvement and learning, and was actively involved in primary care research.
• 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 was an area of practice where the provider needs to make improvements.

Importantly the provider should;

• Ensure patients with a learning disability receive annual health checks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice