Letter from the Chief Inspector of General Practice
Groby Surgery (the provider) had been inspected previously on the following dates:
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9 May 2017 under the comprehensive inspection programme. The practice was rated Inadequate overall and placed in special measures for a period of six months. Breaches of legal requirements were found in relation to safe care and treatment, safeguarding service users from abuse and improper treatment and governance arrangements within the practice. Warning notices were issued which required them to achieve compliance with the regulations set out in the warning notices by 15 September 2017.
Reports from our previous inspections can be found by selecting the ‘all reports’ link for Groby Surgery on our website at www.cqc.org.uk.
This inspection was undertaken following a six month period of special measures and was an announced comprehensive inspection on 11January 2018.
This practice is rated as Good overall. (Previous inspection May 2017 was Inadequate).
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? – Requires Improvement
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 retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) – Good
At this inspection we found:
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Significant improvements had been made since the inspection in May 2017.
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A leadership structure was in place but we were still not assured that the GP partners had the necessary experience to lead effectively. They were unable to fully demonstrate overall clinical oversight and capability to deliver high quality care.
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We found an improved system in place for reporting and recording significant events, lessons were shared to make sure action was taken to improve safety in the practice. Further work was required to evidence patient impact and outcomes.
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Staff understood their responsibilities to raise concerns and report incidents. These were discussed with relevant staff on a regular basis.
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An effective system was in place to safeguard patients from abuse and improper treatment.
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Patients’ health were monitored in a timely manner to ensure medicines were being used safely and followed up on appropriately.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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Feedback we received from patients reflected positively about the staff and said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
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We saw that the practice were aware of the reduced performance in the recent GP survey results published in July 2017. The practice had gone on to undertake their own survey in November 2017 and action plans were in plan to drive improvements to patient satisfaction.
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The practice had made improvements to their governance arrangements and had taken a lot of the appropriate steps required to ensure patients remained safe. Further work was still required in regard to significant events and quality improvement to improve patient outcomes.
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There was limited innovation, service development and improvement.
The areas where the provider should make improvements are:
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Ensure GP partners have the necessary experience to lead effectively. They must be able to demonstrate overall clinical oversight and capability to lead effectively to deliver high quality care.
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Continue to embed the improved system in place for reporting and recording significant events to ensure there is evidence of patient impact and outcomes where appropriate.
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Review the system in place for the monitoring of emergency equipment and medicines and ensure it is carried out as per practice policies.
- Provide guidance and training for staff in the recognition of Sepsis
- Improve the monitoring of prescribing to ensure it is in line with national clinical guidance and current best practice. For example, antimicrobials.
- Continue the plan to drive improvement through clinical audit to ensure it is embedded and changes monitored to sustain improvement.
- Implement the NHS England Accessible Information Standard.
- Continue to monitor the National Patient Survey data and continue to make changes to improve the experience of patients.
- Consider an audit of the process for consent to ensure it is accurately recorded on the patient record.
- Put a plan in place to ensure the practice nurse has regular clinical supervision which is documented.
- Ensure discussions on poor performance are documented.
- Continue to review meeting minutes to ensure they contain details of the discussions that have taken place and actions identified are completed.
I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice