We carried out an announced comprehensive inspection at The Village Practice on 15 January 2019 as part of our inspection programme. 

The practice had merged with another local practice in April 2018 and were in the process of submitting changes to their CQC registration. Following the inspection, the practice submitted a formal request to CQC to change their registered name from The Village Practice to The Village Group Practice, Armthorpe Surgery & Auckley Surgery. This change took place on 30 January 2019.

There was an impact on the inspection in respect of the merger as some records could not be separated to ensure the evidence could be attributed solely to The Village Practice. This was because:

• The merger had involved changes to the IT system to merge the patient records and we were told some information from prior to the merger was not available due to this.
• The separate patient lists were now classed as one list and patients could access both sites for appointments so we could not be sure all the patient’s comments received during the inspection were attributable to The Village Practice.
• Staff from both practices were now working as one team and worked across both sites as required. Management records and systems such as staff recruitment and training were in the process of being merged and reviewed to ensure a consistent approach. We were told some staff recruitment  records remained at the other site.
• The policies and procedures were in the process of being reviewed and implemented across both sites.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

• The practice did not have clear systems and processes to assess and mitigate risks to keep patients safe.

We rated the practice as good for providing effective, caring, responsive services and well led services because:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review and implement the recruitment policy and procedures and records to evidence that staffs physical and mental health conditions, which are relevant to the staff ability to carry on, manage or work for the practice are considered as part of the recruitment process.
• Review and improve systems to monitor patients prescribed high risk medicines.
• Review and improve systems of appraisal for administration staff.
• Review and improve systems to monitor staff training.
• Review and improve patient access to the complaints procedure.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Practice on 6 January 2015. Overall the practice is rated as good.

Specifically we rated the practice as good in providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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.
• 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.
• 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.

We saw two areas of outstanding practice:

• All staff within the practice were dementia friends trained. This helped to offer the patient a better overall experience in meeting their needs. Dementia Friends training supports people to learn more about what it is like to live with dementia.
• The practice had easy read books available during consultations to assist patients with a learning disability to understand conversations about their treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice