We carried out an announced comprehensive inspection at The Witterings Medical Centre on 8 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for safe, effective, caring, responsive and well led. They have been rated as good for all population groups.

We rated the practice good because:

• 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.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had good facilities and was well equipped to treat patients and meet their needs. The premises were clean and hygienic.
• Risks to patients, staff and visitors were assessed, monitored and managed in an effective manner.
• The practice sought feedback from patients, which it acted on.
• Results from the national GP patient survey and feedback from patient comments cards showed high levels of patient satisfaction.
• Staff had the skills, knowledge and training they needed to carry out their roles effectively.
• There was a strong ethos of corporate social responsibility and the practice worked closely with patients’ groups other organisations to provide a community ‘hub’.
• The practice could refer vulnerable patients to a social prescriber, based at the practice who worked with individual patients to provide support on a range of issues such as loneliness, housing, employment and retraining, debt management and benefits.
• There was a strong emphasis of the wellbeing of staff. Staff felt valued and enjoyed working for the practice
• The practice was committed to continuous improvements and innovation and had implemented several quality initiatives.
• The practice had received a ’Mental Health Pace Setter’ award from a national mental health charity and the local clinical commissioning group for the provision of information on postnatal depression to new parents.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

Whilst we found no breaches of regulations, the provider should:

• Improve the uptake for cervical screening to ensure at least 80% coverage in line Public Health England screening targets.
• Review the quality of data submitted for childhood immunisations and ensure that reported rates are accurate.
• Work with the acute hospital trust and the GP practices in the locality to ensure that patients on anti-coagulant medicines are monitored appropriately.

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 The Witterings Health Centre on 10 May 2016. 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, discussion and analysis of significant events. However the recording and cross referencing of the events were not always easy to follow.
• 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.
• Patients said they could make an appointment with a named GP and 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.

• The practice ran a Patient Information Centre which was staffed regularly by volunteers to provide advice on chronic disease management and healthy living.

• 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.

The areas where the provider should make improvement are:

To make the recording of significant events and complaints clearer.

To increase the number of patients with dementia that had their care reviewed in a face to face meeting.

To assess the reasons for the high rate of exception reporting in the Quality and Outcomes Framework for COPD patients, and for diabetic patients who had had an influenza immunisation in the last year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This follow-up inspection was carried out to check that the provider had taken steps which ensured that sterile equipment in the practice was date checked. We found that the provider was now compliant in this area.

We inspected The Witterings Medical Centre to look at the care and treatment provided by staff to the patients of the practice. During our visit we spoke with three patients and one relative of a patient. We also spoke with six members of staff (which included the practice manager and the registered manager) and two other staff associated with the practice. We collected seven responses to a questionnaire that we left in the waiting area for patients.

We observed during our visit that staff treated patients with respect. For example, we saw that staff closed doors of the treatments rooms which ensured privacy and dignity to patients. We also noted that reception staff spoke quietly and politely to patients. The patients that we spoke with told us that they felt respected by the staff at the practice. One patient told us “They’re marvellous.”

We found that the practice worked closely with a number of other healthcare professionals and services. Patients who had been referred outside of the practice told us that the process had been smooth and efficient. One patient we spoke with said “The communication between here and the hospital was very good.”

We found that staff were aware of procedures around safeguarding vulnerable adults and children. We saw that the practice had relevant safeguarding policies and guidance and there was a lead contact for this at the practice.

We found the centre very hygienic and clean. However we saw during our visit that the provider had not ensured that patients were protected from the risk of infection from unsterile equipment.

The practice had a complaints procedure which was made available to patients. The patients we spoke with were very happy with the service they received from The Witterings Medical Centre. One patient told us “It’s like an old cottage hospital.”