Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Bridgeside Surgery on the 2 December 2014. Overall the practice is rated as requires improvement.
Specifically, we found the practice to require improvement for providing safe and well led services. The concerns which led to these ratings apply to everyone using the practice. Therefore the different population group are also rated as requires improvement. The practice was rated as good for providing a caring effective and responsive service.
Bridgeside Surgery provides general medical services to people living in Hailsham. The practice is situated in a residential area. At the time of our inspection there were approximately 5,200 patients registered at the practice with a team of two GP Partners. A third GP was in the process of registering as a partner with the practice via the CQC.
The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. However, there was no written strategy as to how the practice would cope with key members of staff leaving and increasing patient numbers due to new housing developments in the area. Recruitment files we reviewed did not contain the required information and staff appraisals had not taken place on an annual basis. However, there was a culture of openness and transparency within the practice and staff told us they felt supported. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.
The practice has an overall rating of requires improvement.
Our key findings were as follows:
- Patient feedback about the practice and the care and treatment they received was very positive.
- Infection control audits and cleaning schedules were in place and the practice was seen to be clean and tidy
- The practice routinely carried out clinical audits and investigated significant events and complaints.
- Staff told us there was an open/no blame culture and they were supported in their roles.
- An active patient participation group was working in partnership with the practice and there was evidence the practice was listening to it patients.
- There were a range of appointments to suit most patients’ needs and on-line facilities for booking appointments and repeat prescriptions.
- Patients told us they were able to get the time needed with their GPs and did not feel rushed. However, this meant that some patients reported delays in appointment times due to appointments over-running with other patients.
There were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Ensure that all recruitment checks are carried out including risk assessments and recorded as part of the staff recruitment process and that the recruitment policy reflects accurately the procedures necessary. Ensure there is a written risk assessment where decisions have been made regarding staff not receiving a criminal check via the Disclosure and Barring Services (DBS)
- Ensure staff are supported through appraisals.
- Ensure the practice carries out a risk assessment for legionella and has a corresponding policy.
- Ensure all staff have appropriate policies, procedures and guidance to carry out their role.
- Ensure that audit cycles are fully recorded in order to demonstrate actions taken have enhanced care and record where improvements to the service have been made.
In addition the provider should:
- Ensure that patient information is clearly displayed for requesting chaperones
- Ensure that patient information is clearly displayed in relation to the complaints system and contains information of other organisations that can support a complainant.
- Develop a written strategic plan for the practice to include succession planning and how the practice will cope with new building developments which would mean a growing population size.
- Ensure portable electrical equipment is routinely tested and examined and record information relating to this.
- Ensure that staff are trained in safeguarding vulnerable adults.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice