Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wellington Road Family Practice on 25 July 2016. Overall the practice is rated as good. We rated domain of caring as outstanding.

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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice offered flexible access to patients, with the system of open appointment surgeries in the morning and evening. Patients’ needs were accommodated should they contact the surgery and state they were unable to attend during normal hours, we heard how GPs adjusted their hours, stayed later or started earlier should the need arise.
• There were longer appointments available for patients not just for those with a learning disability, or complex health needs.
• Patients with minor injuries were assessed and treated at the practice and if necessary referred to other health providers should the need arise.
• One GP has a special interest in musculo-skeletal medicine and was able to support some patients with treatment at the practice, such as joint injections and acupuncture for pain relief to reduce their need to attend secondary care for treatment.
• The practice staff worked well with patients who had alternative life styles such as the traveller community. The had a positive relationship with the Travellers Liaison Service, and other providers to ensure that there was continuity of care for patients such as ensuring that there was on-going post-natal support when patients moved on.

• The practice staff had a good awareness of domestic abuse and offered appropriate support and a safe haven to patients and others should it be needed.

• The practice hosted sessions for a dietician, counselling service and substance misuse service.

• The practice provided a ‘No Worries’ service offering confidential contraceptive and sexual health services to young people.

• 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 areas of outstanding practice:

• Patients emphasised that they had felt a strong feeling of being cared for as an individual and as a family. Time, whatever the situation, was given to listen to them and their concerns.
• Patients told us there was a whole team approach to ensuring their needs were met. This was reiterated by the representatives of the three care homes, two for older people and one for younger adults, of which the practice GPs provided a personal service to individuals, took the time to listen and explain to patients and their representatives.
• Information for patients about the services available was easy to understand and accessible.
• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
• We were given, by a relative and a health care professional, two examples of the holistic caring approach and the quality of the personal service patient’s relatives received from the practice regarding end of life care.
• We were provided with feedback in regard to the support the GPs provided in the local community. This was within their role as patients’ GPs and in the extra support they gave to local schools; as the safeguarding lead for the clinical commissioning group and their work with the representative of the Identification and referral service(IRIS) for domestic abuse. The senior representatives of the schools told us the extra effort that was made to provide support to vulnerable and at risk young students who were at their schools. This was through providing educational support, a rapid response to assist with a young person’s crisis at the school, providing emergency counselling and clinical help for anxiety, mental health and sexual health.
• Although not formally flagged up by the practice as carers, staff and clinicians recognised the difficulties for some patients and their families to attend the practice. For example, a GP visited a family with twins at home to provide their immunisations so as to reduce the inconvenience and stress for the family to attend the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Wellington Road Family Practice is a small GP practice situated in Yate in South Gloucestershire. The practice supports approximately 2,264 patients from the local community. The practice provides surgeries five days a week and consists of one full-time GP and one part-time GP. There is a system of open appointment surgeries between 9am and 11am and 4pm and 6pm each day, with the exception of Thursday afternoons. The practice offers a booked appointment system for late afternoon surgeries on alternate Tuesdays and Wednesdays for anyone having difficulty attending during normal surgery hours. There is a part-time practice nurse who works three mornings a week.

During the inspection visit we spoke to patients attending the practice and following the visit we spoke with two patient carers who are supported by the practice.

We found the practice delivered the support and treatment patients needed. The practice provided a safe and effective service ensuring that patients had a caring and responsive service. GPs and staff invested time and commitment to ensure the practice was well-led and care was provided in the best interests of their patients.

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 CQC at that time.