This practice is rated as good overall. (Previous inspection 22 September 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Wadhurst Medical Group on 11 April 2018 as part of our inspection programme. The details of the previous inspection can be found by selecting the ‘all reports’ link for Wadhurst Medical Group on our website at www.cqc.org.uk.

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.
• Recruitment procedures kept patients safe.
• 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.
• The practice had a list of mandatory training that all staff should complete and the practice had systems in place to allow them to do so. The practice could not demonstrate that all staff had completed up to date training that the practice considered mandatory.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had appropriate facilities and was well equipped to treat patients and meet their needs.
• Patients reported that they were able to access care when they needed it. Patients said they were able to book an appointment that suited their needs. Pre-bookable, on the day appointments, home visits and phone consultation services were available.
• The practice arranged for frail and vulnerable patients to be visited by appropriately trained health care assistants so that their emotional and social needs as well as their physical needs could be assessed and, where possible, met.
• Staff found the GPs and managers to be approachable and receptive to new ideas.
• Patient survey results were positive and higher than average in some areas in respect of care and treatment.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

The areas where the provider should make improvements are:

• To review and update the fire risk assessment.
• Update the controlled drugs protocol to remove reference to the dispensary.
• To review and improve the format of response letters to complaints and in particular consider always inserting the contact details of the ombudsman.
• To complete the review of and improve the storage of written records.

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 Wadhurst Medical Group on 22 September 2015. 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

The practice had developed a programme that identified patients that may be vulnerable and healthcare assistants undertook home visits to assess needs and provide support to this patient group. Health education and support information was provided to patients and care plans developed to meet each patient’s needs.

There were areas that the provider should make improvements :

The provider should:

• Ensure the action plan to update all staff appraisals is completed.
• Healthcare assistants who carry out home visits are supported with a risk assessment for this activity.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We used a number of different methods to help us understand the experiences of people who used the service. We talked with eight people who used the service, one who was the chairperson of the practice's Patient Participation Group (PPG). We observed interaction between staff and people who used the service. We reviewed records and systems. We looked at the environment in the Belmont and Frant surgeries and how this impacted on the service delivery. We spoke with staff including; the deputy practice manager, two practice nurses, the dispensary manager and a dispenser, the reception manager and a receptionist. We also spoke with two of the GP’s in the partnership.

This told us that people who used the service care needs had been assessed; they had time to discuss their health care issues, and had been fully involved in making decisions about their care and treatment. Comments from people who used the service included: “This is the best doctors surgery I have been to. They are all very keen to ensure your wellbeing is good,” and “I can’t fault them. We have always had a very good service.”

People were not protected fully protected from the risk of infection because not all the appropriate guidance had been implemented.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Recruitment and other procedures were not fully followed to protect people who used the service.

There was an annual patient survey carried out, and there were arrangements for the practice to monitor standards of quality and safety.