12 September 2018
During a routine inspection
This practice is rated as Good overall. (Previous inspection August 2017 – Requires improvement)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
In August 2017 we undertook a comprehensive inspection at The Wellington Practice. As a result of the inspection we issued requirement notices and issued a rating of requires improvement for providing safe, effective and well-led services. We carried out an announced follow up comprehensive inspection at The Wellington Practice on 12 September 2018 as part of our inspection programme and to identify if improvements required at our previous inspection had been made. We found significant improvement to services had been achieved. However, the practice still requires improvements in providing effective services to patients.
At this inspection we found:
- The practice had clear systems to manage risks to patients and staff. When incidents occurred, the practice learned from them and improved their processes.
- The practice did not consistently monitor the effectiveness and appropriateness of the care it provided to ensure treatment was always appropriate. National data indicators showed there was poor performance in some clinical areas. The practice has a challenges in terms complex disease profiles and the transient nature of its population.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they could access care when they needed it.
- There was an improved focus on learning and improvement since 2017.
- The practice continuously reviewed the needs of its patient population and adapted processes to improve services for its population.
We saw one area of outstanding practice:
The practice had enlisted the expertise of an external GP to help with reviewing and deciding on which action to take following significant events. This was aimed at providing an independent and objective review of events which may enhance the learning culture of the practice. The external GP attended the meetings where events were discussed. We saw this led to improvements in process being identified and implemented.
The areas where the provider must make improvements are:
- Improve the monitoring and processes to drive improvement in patient care.
Additionally, the provider should:
- Review the process for ensuring spirometers are accurate and fit for use.
- Review the location of oxygen cylinders which may be required in an emergency is known to all staff.
- Identify means of identifying carers’ who may require additional support.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice