Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Almhouse Surgery on 8 September 2015. As part of this inspection we also visited the Sandal Castle Medical Centre. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• 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:

• The practice were part of Trinity Care which was a seven day, nurse-led telephone service for same day GP appointments.
• The practice had employed an experienced psychiatric nurse to follow up patients with mental health problems.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. The current practice had formed in 2017 after the merger of two previously individual services The Almshouse Surgery and The Grove Surgery. These had been inspected on 8 September 2015 and 15 September 2015 respectively and had been both rated as Good overall. There was continuity of staffing between the previous providers and the current provider.

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

We carried out an announced comprehensive inspection at Trinity Medical Centre on 8 August 2018 as part of our inspection programme for newly registered providers.

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.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice had worked at both Federation and Confederation level to develop a telephone triage service. This was used to assess requests for same day appointments and home visits. We saw evidence that these developments had made significant workforce efficiency savings and prioritised services according to assessed need.

The areas where the provider

should

make improvements are:

• Review and improve assurance that medication reviews were being undertaken in line with the practice service policy.
• Review and improve assurance in respect to confirming the immunity status of appropriate staff in relation to measles, mumps and rubella, and chickenpox.
• Review and improve the fixing cords to window blinds securely to prevent entanglement.
• Review and improve patient confidentiality at the reception desk at the main Trinity Medical Centre site.
• Review and improve the identification and recording of patients who acted as carers for others.
• Review and improve the appraisal process to ensure staff receive these on a regular basis.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice