Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Liphook and Liss Surgery on 21 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long term conditions, families children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). It required improvement for providing safe services.

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 well managed, with the exception of those relating to fire safety.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• 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.
• Patients had the facility to attend the practice’s other site that had different late night and Saturday opening if this is more convenient for them.
• The practice delivered medicines to housebound patients.
• The practice used photography as a means of diagnosis and comparison of GP diagnostic skills.
• The practice had a very detailed carer’s policy which they shared widely. The support they offered carers included, telephone ordering of prescriptions, flexibility and priority of appointment times and home visits to address the carers own health issues. The practice offered support for carers to document a plan for the person they cared for should the carer have a medical emergency. There was an opportunity for carers to get together advertised in the waiting room which was supported by the practice and patient participation group.
• The patient participation group (PPG), supported by the practice GPs organised an information evening, with guest speakers, on the subject of dementia. The event was publicised in the local press and was open to all people in the area.

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

Importantly the provider must:

• Ensure a full risk assessment is in place for the management of fire safety. Staff must receive training in relation to fire safety.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with eight patients, ten members of staff (including four GPs) and reviewed records in relation to five patients. The practice operated from two surgeries a few miles apart serving two communities totalling approximately 10,500 patients.

Patients were happy with the care provided. One patient said “Everyone, from the doctors, the nurses, to the girls are fantastic. They make you feel very comfortable.” Another patient said “It’s a really caring practice here. You feel everyone puts themselves out to help you. I can’t speak highly enough of them.”

There were effective systems in place to reduce the risk and spread of infection. During our inspection we observed that the surgery was clean. We saw that offices and clinical rooms were clean, surfaces, trolleys and couches, curtains and curtain rails were all clean. The reception area, waiting area and toilets were clean and there were hand washing notices at all the sinks.

Controlled drugs were stored separately in a controlled drugs cabinet which was secured to the wall. We checked three items contained in the CD cabinet. The checks confirmed that the amounts noted in the controlled drugs register agreed with the CD cabinet content. The accountable officer for controlled drugs visited the dispensaries on a regular basis and carried out audits of the controlled drugs registers.

Appropriate checks were undertaken before staff started work. For all eight of the GP partners and one salaried doctor we saw evidence that they were on the primary medical performers list. GPs must be included on the performers list in order to provide primary medical services and detailed checks are carried out before a GP can be included on the list.

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of The Liphook and Liss Surgery in October 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at The Liphook and Liss Surgery on 21 July 2015 when we rated the practice as good overall. The practice was rated as good for being effective, caring, responsive and well-led and requires improvement for providing safe care. This was because we found that risks to patients and staff in relation to fire safety had not been fully assessed, and there was no record of fire safety training for staff. Following our last inspection we asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time.

The practice was able to demonstrate that they were meeting the standards for safe care and is now rated as good for providing safe care. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report.

Our key findings across the areas we inspected in October 2016 were as follows:

• There were full risk assessments in place for the management of fire safety at both branches of the practice, and staff had received appropriate training in relation to fire safety.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice