Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Danby Surgery on 13 and 14 October 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
- Risks to patients were assessed and well managed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
- Feedback from patients about their care and treatment was consistently positive. Data from the national GP patient survey showed patients rated the practice higher than others for all aspects of care.
- Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this.
- The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs.
- The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG).
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- The practice actively reviewed complaints and made improvements as a result.
- High standards were promoted and owned by all practice staff, and teams worked together across all roles.
- Governance and performance management arrangements were proactively reviewed and reflected best practice.
- The staff demonstrated a strong collaboration, commitment and a common focus on improving quality of care and people’s experiences.
- The patient participation group was active.
- There was a strong focus on continuous learning and improvement at all levels within the practice.
We saw three areas of outstanding practice including:
- The practice provided a weekly GP clinic at a local residential care service for people with a learning disability. At the time of our inspection the practice had 93 adults on their learning disability register (4% of the practice population), 89 of whom lived at this service. Appointments for people with a learning disability were between 15 and 30 minutes long dependent on individual need.
- The practice was proactive in engaging with the local community. Several members of staff attended local community events where they spoke about a range of initiatives. For example the senior administrator had attended and spoke about the benefits and availability of flu vaccines which resulted in an increased uptake. The community practice nurse had attended and spoken about falls and how to reduce them. This had resulted in a number of patients being identified who would benefit from a personalised care plan as part of the admissions avoidance project.
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To support independence and the safe use of medicines for many elderly patients who often lived alone, the practice dispensed medication into blister-packs (medication dosing systems). This included electronic dosing systems for patients with complex medication and special needs so they could maintain their independence whilst taking medication safely. Depending on their needs, patients received a medication administration chart or a large-print list of medication with information on their purpose and dosing.
However there was one area of practice where the provider should make improvements:
- Review the current procedures in relation to near misses to cover all aspects of the dispensing process.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice