Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Ripon Spa Surgery on 14 November 2016. The findings at that inspection led to an overall rating for the practice of requires improvement. We also issued three requirement notices for breaches in regulations relating to the Health and Social Care Act 2008. The full comprehensive report for that inspection can be found by selecting the ‘all reports’ link for Ripon Spa Surgery on our website at www.cqc.org.uk.
This inspection was an announced comprehensive inspection on 30 August 2017. Overall the practice is now rated as good.
Our key findings were as follows:
- Systems and processes had been improved and were now embedded within the practice. These included comprehensive processes in place regarding infection prevention and control, medicines management, recruitment, training and appropriate supervision of staff.
- There was evidence of actions, shared learning and reviews of any changes undertaken in relation to reported incidents or near misses.
- We saw that a programme of clinical and non-clinical audit was in place. There was evidence to demonstrate quality improvement as a result of the audits that had been undertaken.
- There was an effective process in place for obtaining patient consent for specific procedures. Consent was clearly documented in a patient’s record.
- There was a system in place and an identified person to support the summarising of patient records.
- There was a system in place to ensure all policies and procedures were in date, reviewed as appropriate and that staff knew where to access them.
- A range of clinical and non-clinical meetings took place within the practice. We saw formal minutes arising from those meetings.
- We saw evidence that staff were up to date with their appraisals and mandatory training; which included safeguarding, mental capacity of patients, infection prevention and control, fire safety and basic life support.
- There was evidence that governance arrangements within the practice were effective. Risks and issues were identified and dealt with accordingly.
- The practice delivered enhanced services and participated in programmes to meet the needs of their patient population.
- There was evidence of strong teamwork and a commitment to deliver a quality service to patients. Staff were clearly valued by the partners in the practice.
- Patients’ comments we received were extremely positive and demonstrated they held the practice and staff that worked there in high regard.
We saw an area of outstanding practice:
- There was evidence of a caring practice, where staff had ‘gone the extra mile’ for patients. For example, providing food, transport and presents for patients who were in poverty or homeless. Dispensing staff had taken prescriptions to patients if they had difficulty getting to the practice due to ill health. The GPs provided their personal mobile numbers to patients with palliative care needs, and/or their families. This allowed for them to contact their own GP at the weekend, during bank holidays or out of normal practice hours. Opportunistic home visits were undertaken on patients who staff may have had some concerns about.
There was an area where the provider should make improvements:
- Ensure that the backlog of the summarising of patient records is completed in a timely way.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice