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his practice is rated as Good overall. (Previous rating Sept 2017 – Requires Improvement)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires Improvement

We carried out an announced comprehensive inspection at West View Medical Surgery on 19 October 2018. This was to follow up on previous breaches of regulations identified at out last inspection of this practice in September 2017. At our previous inspection, we rated the practice as requires improvement overall, as well as for being safe, effective and well led. We rated the practice as good for being responsive and caring.

At this inspection we found:

• The practice had 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. However, they did not always record evidence of monitoring activity to provide assurance of safety systems. We were not assured of the governance processes for infection control, recruitment, checking equipment and medicines and evidencing the action they had taken in relation to patient safety alerts.
• The practice had a programme of quality improvement activity and had started to review the effectiveness and appropriateness of the care provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had a clear vision and credible strategy to deliver high quality, sustainable care. Leadership arrangements had improved. However, there were still areas where the governance processes were not fully embedded or did not demonstrate effective monitoring and control.

The area where the practice must make improvement are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

The areas where the provider should make improvements are:

• Continue to develop their approach to quality improvement and clinical audit to ensure there is a strong link between activity taken and the improvement of outcomes for patients.
• Develop effective system to increase identification of patients who are also carers to ensure they are receiving the support they need to stay healthy and well.
• Review the emergency medicines held by the practice to enable them to deal with medical emergencies. Where the practice decides not to hold a medicine recommended by the UK Resuscitation Council, make sure there is an appropriate risk assessment in place to support this decision.

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.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West View Surgery on 28 September 2017. Overall the practice is rated as requires improvement.

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.

• The arrangements for managing medicines, including emergency drugs and vaccinations, in the practice kept patients safe.

• Data from the Quality and Outcomes Framework (QOF) for 2016/17 showed that patient outcomes were below average at 94.3% when compared to local and national averages, however they had improved compared to the previous year’s results which were 93.2%.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Access to appointments was good; the practice had carried out audits and a survey to ensure this.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice was aware of and complied with the requirements of the duty of candour.

The areas where the practice must make improvements are;

• Ensure there are effective systems and processes in place for the management of significant events and patients safety alerts are comprehensive.

• Ensure there are measures in place to mitigate the risks of health and safety to patients and the staff who use or work at the practice.

• Ensure a programme is in place for two cycle clinical audit which is clearly linked to patient outcomes.

• Ensure that practice policies and procedures are comprehensive and followed.

• Ensure that basic staff training is identified for each role within the practice.

• Ensure staff receive appropriate training in order to carry out the duties they perform and maintain accurate records of this and ensure staff receive an annual appraisal.

• Ensure recruitment procedures are established and operate effectively.

The areas where the provider should make improvements are:

• Have regular face to face staff meetings,

  to encourage whole team learning and to disseminate good practice

  .

• Continue to recruit patients to form a patient participation group.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice