This practice is rated as Good overall. The practice was previously inspected in November 2015 and was rated as good overall. At the 2015 inspection the practice was rated as good for effective, caring, responsive and well led. It was rated as requires improvement for safe.

At this inspection the key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at The Vale Surgery on 23 October 2018.

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 had implemented defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Information about services and how to complain was available.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The area where the provider should make improvements is:

• Review the availability of appointments on the basis of patient feedback.
• Review how the practice identifies carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Vale Surgery on 03 November 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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 but not always well managed. There was no defibrillator on the premises on the day of inspection and no risk assessment had been completed. A Disclosure and Barring Service (DBS) check had not been carried out for a GP prior to employment. We saw that the practice implemented immediate action plans to rectify these issues.

• Patients’ needs were assessed and care was planned but not always delivered in line with relevant guidance and legislation; consent for examinations and discussions with patients were not always recorded but the practice took immediate actions to address this.

• 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. Patients said they were treated with compassion, dignity and respect. The practice had addressed less positive feedback from patients. Information about services and how to complain was available.

• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on. The practice had a number of policies and procedures to govern activity, but not all staff knew how to locate them.

• The practice had access to but did not hold recruitment and training files on the premises for some staff members.

• The practice held regular governance meetings where issues were discussed and appraisals were carried out for all members of staff. Not all staff had received mandatory training appropriate to their roles but further training needs had been identified or planned.

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

The provider should:

• Ensure recruitment arrangements include DBS checks for all locum staff or a risk assessment for non-clinical staff.
• Ensure all staff are aware of how to access policies and procedures.
• Ensure details of examinations, discussions with patients and the process for seeking consent are documented.
• Ensure all staff know how to use the defibrillator and all staff receive mandatory annual basic life support and safeguarding training.
• Ensure copies of recruitment and training files and immunisation records for all staff are kept on the premises.
• Ensure there is a cleaning schedule in place to ensure all equipment is cleaned.
• Consider carrying out practice patient surveys to continuously monitor feedback and identify areas for improvement.
• Ensure notices are available to inform patients of translation services available.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice