Sibford Surgery

Updated 25 January 2017

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of Sibford Surgery in December 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at Sibford Surgery on 4 May 2016 when we rated the practice as good overall. The practice was rated as good for being effective, caring, responsive and well-led and requires improvement for providing safe care. This was because we found that risks to patients and staff in relation to the management and dispensing of medicines and infection control were not being fully assessed, monitored, managed and mitigated.

Following our last inspection we asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time, in relation to its management of medicine fridge temperatures, the checking of dispensed medicines, ensuring that medicines and vaccines were administered in accordance with directives, auditing and following infection control guidance, and ensuring that fire risks were identified and managed.

The practice was able to demonstrate that they were meeting the standards for safe care and is now rated as good for providing safe care. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report.

Our key findings across the areas we inspected in December 2016 were as follows:

• There were systems in place to ensure the effective daily monitoring of medicine fridge temperatures, the checking of dispensed medicines from manually amended prescriptions, the administration of medicines and vaccines in accordance with legislations, the auditing and following of infection control guidance, and identifying and managing fire risks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 June 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The most recent published results were 98% of the total number of points available compared to the clinical commissioning group (CCG) average of 97% and national average of 95%.
• The practice has a rate of 5% exception reporting compared to the national average of 9% and regional average of 8%.Performance for diabetes related indicators was 88% compared to the national average of 89% and regional average of 93%. Diabetes exception reporting was 7% compared to the CCG average of 12%.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Patients had access to their medicines for any health conditions via the dispensary.

Updated 14 June 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.
• Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• Joint working with external organisations took place in the management of children at risk of abuse.

Updated 14 June 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The premises were accessible for patients with limited mobility and poor hearing.
• All Appointments were available on the ground floor.
• Patients over 75 had a named GP.
• Eligible patients had access to their medicines for any health conditions via the dispensary

Updated 14 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• Patients’ feedback on the appointment system was very positive overall.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Travel vaccinations were available.
• Extended hours were available on Thursday evenings until 8pm, which was valuable to patients who commuted.

Updated 14 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Performance for mental health related indicators was 100% compared to the national average 92% and regional average of 95%.
• There were 14 patients on the mental health conditions register and 10 had a care plan in place. Twelve patients had a physical health check.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advanced care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 14 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• Joint working with external organisations took place in the management of patients at risk of abuse or harm, although the practice rarely attended these meetings.