We carried out an announced focused inspection at Dr Stephenson and partners on 22 October 2019 as part of our inspection programme.
We decided to undertake an inspection of this service following our annual review of the information available to us.
Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions:
- Is the practice effective?
- Is the practice responsive?
- Is the practice well-led?
Because of the assurance received from our review of information we carried forward the ratings for the following key questions:
- Is the practice safe? – (Good- January 2016)
- Is the practice caring? – (Outstanding- January 2016)
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 Outstanding overall.
We rated the practice as outstanding for providing effective services because:
- There was a holistic approach to assessing, planning and delivering care and treatment to patients who use services.
- Staff were highly engaged in activities to monitor and improve quality and outcomes and high performance is recognised by external bodies.
We rated the practice as outstanding for providing well-led services because:
- The leadership governance and culture at the practice drives and improves the delivery of high-quality person-centred care.
- There was strong collaboration in working with other organisations to improve care outcomes and tackle health inequalities.
We found that:
- The practice had systems to keep clinicians up to date with current evidence-based practice. We saw that clinicians assessed needs and delivered care and treatment in line with current legislation, standards and guidance.
- Care was delivered and reviewed in a coordinated way when different teams, services or organisations are involved. There was a clear ethos of working in partnership to meet the needs of patients, particularly those most vulnerable and most at risk of otherwise not having good access to healthcare.
- The practice had a programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided. We saw this was integral to how the practice monitored and improved the way they worked.
- We found staff had the knowledge and skills needed to provide effective care.
- The practice demonstrated they had good governance processes to monitor and improve safety and safeguarding within the practice.
- There was a clear vision and strategy to deliver high quality, sustainable care. The practice was clearly linked in with other organisations to help them deliver effective, targeted, coordinated health care to their population. There was a clear ethos of no one left behind.
- There were arrangements in place to support good governance and management. The practice has an in depth knowledge of their own performance. Where areas for improvement were identified the practice developed and implemented action plans to support improvements.
- The practice culture was clearly to innovate to support sustainability and good quality care.
- The practice had clear and effective processes for managing risks, issues and performance. These were well embedded and kept the practice up to date with what actions were needed.
- The practice learned, improved and innovated as a result of safety information and incidents.
We saw examples of outstanding practice:
- The practice had all-encompassing systems and processes in place to ensure that patients received high quality care and treatment. This included a team who monitored the searches for reviews of certain conditions. The multi-disciplinary team meeting process had ensured improvements in patient care and had reduced hospital admissions and accident and emergency attendances.
- The practice had a social prescriber who worked as a link worker to support and help patients to be referred to local non-clinical services to support their wellbeing. This included patients who were carers, patients with dementia, war veterans, those needing help from food banks and victims of domestic abuse. The practice had strong processes in place to help victims of domestic abuse and one the GPs was the lead for this.
- The practice had carried out a significant amount of audits and other quality improvement work to enhance patient care.
The area where the provider should make improvements are:
- Evaluate the outcome of the new telephone system and the assess the impact it has had on patients being able to make an appointment.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care