Background to this inspection
Updated
12 August 2016
Axbridge and Wedmore Medical Practice are located in a rural area of Somerset. They have approximately 8400 patients registered who are of a White British ethnicity.
The practice operates from two locations:
Axbridge Surgery
Houlgate Way
Axbridge BS26 2BJ
And
Wedmore Surgery
St. Medard Road
Wedmore BS28 4AN
The practice is made up of four GP partners and four salaried GP working alongside qualified nurses and health care assistants who work at both locations. The practice has a general medical service contract and also has some additional enhanced services such as unplanned admission avoidance. The Axbridge Surgery is open Monday – Friday, 8am - 6.30pm and Wedmore Surgery Monday & Friday 8am - 6.30pm, Tuesday, Wednesday and Thursday 8am-1.00pm. Extended hours with pre-bookable appointments are available on Wednesday and Thursday 6.30pm - 8pm at Axbridge Surgery on alternate weeks; and at the Wedmore Surgery on Wednesday and Thursday 7am - 8am once a month, and Saturday8am - 9.30am on alternateweeks.
The practice does not provide out of hour’s services to its patients, contact information for this service is available in the practice and on the website.
Patient Age Distribution
0-4 years old: 3.9%
5-14 years old: 12.6%
Under 18 years: 17%
65-74 years old: 21.2%
75-84 years old: 8.2%
85+ years old: 2.2%
Information from NHS England indicates the practice is in an area of low deprivation with a lower than national average number of patients with long standing health conditions, a higher than average number of patients with caring responsibilities and high levels of employment. The patient gender distribution was male 49.5% and female 51.5%.
The practice does not participate in the national quality and outcomes framework but is part of the Somerset Practice Quality Scheme. The practice has Wi-Fi at both sites for patients to access.
Updated
12 August 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Axbridge and Wedmore Practice on 15 May 2015. Following our comprehensive inspection overall the practice was rated as requires improvement specifically for the safe and well led domains. Following that inspection we issued two requirement notices. These notices were due to a breach of Regulation 15 of The Health and Social Care Act (Regulated Activity) Regulations 2014, Premises and Equipment and Regulation 17 Good Governance. The requirement notices were for the practice to implement the necessary changes to ensure patients who used the service were protected against the risks associated with infection prevention, the other requirement notice was for the practice to monitor the quality and safety of the service. A copy of the report detailing our findings can be found on our website at www.cqc.org.uk.
Our previous key findings across the areas we had inspected were as follows:
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The practice needed to ensure there was a building maintenance programme in place.
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The practice needed to ensure there was a process to undertake regular risk assessments of the environment in order to identify any potential risks to patients’ safety.
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The practice needed to ensure the cleaning schedule was effective, in order to maintain the hygiene and cleanliness of the practice.
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The practice needed to review the protocols they had in place for patient safety, to ensure staff was able to put them into practice, in the areas such as. emergency protocols, cold chain protocols, safeguarding protocols.
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The practice needed to fully implement the recruitment policy to evidence that patients were protected from the risk of the employment of unsuitable staff.
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The practice needed to ensure staff were appropriately trained for the roles they fulfilled such as the administering of vaccinations and, chaperone training.
We had also found in addition the provider should:
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
Overall the practice is now rated as good.
Our key findings across the areas we inspected were as follows:
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The practice had a building maintenance programme in place and had addressed areas of concern such as aspects of safety entering and leaving Wedmore Surgery, decoration and refurbishment.
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Risk assessments to identify and monitor risks to the environment were implemented and reviewed regularly.
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Cleaning schedules were in place and practice buildings were kept clean and hygienic.
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Protocols had been reviewed in updated and followed by staff, such as emergency procedures, use of the cold chain and safeguarding vulnerable adults and children.
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The records for recruitment showed that some but not all aspects of their recruitment policy and procedure had been recorded in detail appropriately.
The areas identified during this focused inspection, where the provider should make improvement are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including people with long term conditions who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
Families, children and young people
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including families, children and young people who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including older people who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
Working age people (including those recently retired and students)
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including working age people who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
People experiencing poor mental health (including people with dementia)
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including people experiencing poor mental health who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.
People whose circumstances may make them vulnerable
Updated
12 August 2016
We carried out an announced focused inspection at Axbridge and Wedmore Practice on 20 June 2016 to follow up the requirements and to assess if the practice had implemented the changes necessary to ensure patients including people whose circumstances may make them vulnerable who used the service were protected against the risks associated with infection prevention and lack of monitoring of the quality and safety of the service.