This practice is rated as Good overall. The practice changed its main location in March 2017 and this is the first inspection since that change.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

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 Vista Road Surgery on 07 November 2018. This was a part of our inspection program.

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.
• There were effective methods of engaging with the community projects and the public.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a clear leadership structure and staff felt supported by management.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Patients found they could access routine and urgent appointments, however patients stated they had to wait a long time to see the clinician of their choice.
• There were gaps in some aspects of medicines management.
• Paper records were not always stored completely in line with personal information security legislation.
• The systems in place were insufficient to ensure that the premises were cleaned to a suitable standard.

We saw one area of outstanding practice:

• The practice was outstanding in collaboration with outside agencies and methods used to encourage patient engagement with health promotion projects, for example, the practice had worked with a charitable trust to distribute cold weather advice and a cold weather risk reduction pack to older patients. These were distributed when patients received their flu vaccines and home visits. The pack contained information about minimising the effects of cold weather and practical items which included, a radiator key, a torch and a room thermometer. Information about how to reduce social isolation was also included. The practice had distributed 50 packs and the plan was to offer a pack to eligible patients at their appointment.

The areas where the provider

must

make improvements are:

• The provider must ensure medicines are managed safely and all infection control risk assessments are completed and the appropriate mitigating action taken.

The areas where the provider

should

make improvements are:

• Extend the use of clinical audits to include using the results to action changes to improve the standard of care and treatment provided.
• Update the safeguarding policy and procedure to include information about all types of abuse and safeguarding concerns.
• Develop systems that will assure that all policies, procedures and activities are operating as intended.
• Ensure there is a cleaning rota for the building which is monitored.
• Provide front of house staff with training in recognising and dealing with the early signs of sepsis.
• Develop a register of patients in vulnerable situations.
• Monitor the processes for obtaining consent from patients.
• Act to assure themselves that staff who are on placement have been appropriately vetted to work with children and vulnerable adults.
• Consider reviewing how performance data is inputted.
• Put systems in place to ensure paper documents are always kept secure.
• Risk assess the choice of emergency medicines provided and carried in the doctors’ bags.

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.