This practice is rated as Requires Improvement overall. (September 2018)

We carried out an announced focused inspection at Wincanton Health Centre on 8 February 2019. This inspection was carried out to follow up on breaches of regulations and areas identified as for improvement where we had rated the key questions of safe and effective and the patient population groups of people with long-term conditions and mental health needs as requires improvement. We had implemented one regulatory requirement, Regulation 12 – Safe care and treatment and a small number of areas the provider should take action to improve.

These were:

Safe.

• The provider must have the necessary information available to support that staff have been recruited appropriately and suitable for their role and that the information regarding their immunisation status is sought and kept.
• The provider must monitor and address the gaps in clinical staff available required to maintain meeting the patient’s needs including patients with long term conditions and mental health needs.
• The provider must have safe systems in place for fire safety, training for persons undertaking risk assessments, infection control and chemicals stored and used at the practice.
• The provider must continue with assessing and putting actions in place to ensure medicines are stored safely and that sufficient stock of Oxygen is kept at the practice.
• The provider must continue to review the safe storage and handling of prescription stationery.
• The provider should continue with having an effective system for responding and investigating significant events.

Effective:

• The provider should continue with a full programme to provide staff with the necessary training for health and safety.
• The practice should continue to resolve meeting the needs of the patients with long term conditions and with mental health concerns.

In other areas:

• The provider should continue to review and embed policies and procedures.
• The practice should continue to proactively identify carers and respond to patient feedback regarding access.

At this inspection we found:

• The practice had implemented safe systems that had been sustained to manage risks associated with the recruitment and employment of staff, fire safety, health and safety, medicines management, and safe prescription paper handling.
• Improvements in the system for responding to and investigating significant events had been sustained.
• The practice employed sufficient suitably skilled and experience staff to meet patients’ needs including patients with long-term conditions and mental health needs.
• Policies and procedures and a system of governance had been implemented and embedded.

Areas where the provider should continue to develop:

• The practice should continue to resolve meeting the needs of the patients with long term conditions and with mental health concerns.
• The practice should continue to proactively identify carers.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

This practice is rated as requires improvement overall. (Previous rating September 2014 under a previous provider – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires improvement

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 Wincanton Health Centre on 13 July 2018. This inspection was part of our inspection programme and to check that the new provider, Symphony Healthcare Services, was continuing with providing a Good service since they had assumed responsibility for the service in October 2017.

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 did not always use their systems to review these incidents so that they 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.
• 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.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• There was an active Patient Participation Group that worked with the practice to provide support to the local community.
• Daily scheduled phone calls were made to each care or nursing home by a GP to manage concerns and problems. Paramedics and the practice pharmacist regularly visited these homes to provide support and advice.
• There were new policies and procedures and a new system of governance which needed to have time to be fully implemented and embedded.

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

• The provider must have the necessary information available to support that staff have been recruited appropriately and suitable for their role and that the information regarding their immunisation status is sought and kept.
• The provider must monitor and address the gaps in clinical staff available required to maintain meeting the patient’s needs including patients with long term conditions and mental health needs.
• The provider must have safe systems in place for fire safety, training for persons undertaking risk assessments, infection control and chemicals stored and used at the practice.
• The provider must continue with assessing and putting actions in place to ensure medicines are stored safely and that sufficient stock of Oxygen is kept at the practice.
• The provider must continue to review the safe storage and handling of prescription stationery.

The areas where the provider should make improvements are:

• The provider should continue with having an effective system for responding and investigating significant events.
• The provider should continue to review and embed policies and procedures.
• The provider should continue with a full programme to provide staff with the necessary training for health and safety.
• The practice should continue to proactively identify carers and respond to patient feedback regarding access.
• The practice should continue to resolve meeting the needs of the patients with long term conditions and with mental health concerns.

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.