Letter from the Chief Inspector of General Practice

This practice is rated as Good overall, with outstanding for providing well led services. (Previous inspection report published 29 September 2016 – Good)

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? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Wickham Market Medical Centre on 20 November 2017 as part of our regulatory functions.

At this inspection we found:

• The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes. The practice shared outcomes of significant events with staff and other local GP practices.
• 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. Support and monitoring was in place for the nursing staff, and the monitoring of the work undertaken by the nurse practitioners was formalised and effective.
• Staff involved and treated people with compassion, kindness, dignity and respect. All staff had received equality and diversity training and reception, administration, dispensary staff and the business manager had all completed dementia awareness training.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. Patient feedback on access to appointments was positive; this was supported by a review of the appointment system and data from the national GP Patient Survey.
• The practice had responded to the needs of patients. This included for example, providing a minor injuries service, due to the rural location of the practice. The practice also identified a high number of patients attending with musculoskeletal needs, so arranged physiotherapy services at the practice, where patients could self-refer.
• There was a clear, effective leadership structure, with a strong focus on quality and strategic leadership. The practice strategy, values and mission statement supported this focus. Practice, team and individual objectives were in place. There was evidence of cross team objective setting. Staff felt very supported by management. The practice proactively sought feedback from staff and patients, which it acted on and benchmarked with other local practices.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Innovation was encouraged and included for example, training for reception staff to signpost patients to appropriate health and social support services and triage of emergency appointment requests on behalf of four practices in the Deben Health Group. Outcomes were regularly monitored to ensure that innovation was having the desired impact and remained in line with the practice’s strategy.

We saw two areas of outstanding practice:

• The practice shared outcomes of significant events with staff and members of the Deben Health Group. (A group of eight local GP practices who work together on financial, educational and clinical matters and to share learning and development.) For example the practice shared a significant event, where they had raised a safeguarding alert in relation to a medicine issue at a care home. This raised awareness in the other practices of the need to raise a safeguarding concern in similar circumstances.

• The practice had been awarded the Investors in People award annually for the past 13 years which demonstrates the practice’s commitment to training, supporting and developing its staff. Staff confirmed that they felt empowered and involved in the practice and were supported to develop to their potential.

The areas where the provider should make improvements are:

• Continue with plans to invite patients with a learning disability for a health check.

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 of Wickham Market Medical Centre on 9 February 2016 and found that improvements were necessary in order to comply with the requirements of the Health and Social Care Act 2008.

In February 2016 we found that the provider did not have appropriate arrangements in place to ensure that appropriate systems surrounding the management of controlled drugs were implemented. Controlled drug records were not consistently kept. The practice also had to ensure adequate monitoring of the refrigerators storing vaccines took place and staff knew what to do if the temperature was outside the recommended range.

After the inspection the practice provided us with an action plan to demonstrate how they intended to comply with the requirements of the Health and Social Care Act 2008.We undertook a focused follow up inspection to check that the practice had followed their action plan and to confirm that the requirements of the Health and Social Care Act 2008 had been met.

On the inspection on 2 August 2016 we found that the practice had responded appropriately to address our findings.

This report only covers our findings in relation to the improvements required following our inspection in February 2016. You can read the report from our last comprehensive inspection, by selecting the ‘all reports' link for on our website at www.cqc.org.uk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall, with outstanding for providing well led services. (Previous inspection report published 29 September 2016 – Good)

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? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Wickham Market Medical Centre on 20 November 2017 as part of our regulatory functions.

At this inspection we found:

• The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes. The practice shared outcomes of significant events with staff and other local GP practices.
• 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. Support and monitoring was in place for the nursing staff, and the monitoring of the work undertaken by the nurse practitioners was formalised and effective.
• Staff involved and treated people with compassion, kindness, dignity and respect. All staff had received equality and diversity training and reception, administration, dispensary staff and the business manager had all completed dementia awareness training.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. Patient feedback on access to appointments was positive; this was supported by a review of the appointment system and data from the national GP Patient Survey.
• The practice had responded to the needs of patients. This included for example, providing a minor injuries service, due to the rural location of the practice. The practice also identified a high number of patients attending with musculoskeletal needs, so arranged physiotherapy services at the practice, where patients could self-refer.
• There was a clear, effective leadership structure, with a strong focus on quality and strategic leadership. The practice strategy, values and mission statement supported this focus. Practice, team and individual objectives were in place. There was evidence of cross team objective setting. Staff felt very supported by management. The practice proactively sought feedback from staff and patients, which it acted on and benchmarked with other local practices.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Innovation was encouraged and included for example, training for reception staff to signpost patients to appropriate health and social support services and triage of emergency appointment requests on behalf of four practices in the Deben Health Group. Outcomes were regularly monitored to ensure that innovation was having the desired impact and remained in line with the practice’s strategy.

We saw two areas of outstanding practice:

• The practice shared outcomes of significant events with staff and members of the Deben Health Group. (A group of eight local GP practices who work together on financial, educational and clinical matters and to share learning and development.) For example the practice shared a significant event, where they had raised a safeguarding alert in relation to a medicine issue at a care home. This raised awareness in the other practices of the need to raise a safeguarding concern in similar circumstances.

• The practice had been awarded the Investors in People award annually for the past 13 years which demonstrates the practice’s commitment to training, supporting and developing its staff. Staff confirmed that they felt empowered and involved in the practice and were supported to develop to their potential.

The areas where the provider should make improvements are:

• Continue with plans to invite patients with a learning disability for a health check.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice