This practice is rated as Good overall. (Previous rating November 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Aspatra Medical Group on 7 December 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a focus on continuous learning and improvement at all levels of the organisation.

We saw some areas where the practice should make improvements:

• Progress quickly with plans to ensure prescription stationary is stored securely;
• Make sure all staff are aware of the location of emergency oxygen;
• Follow up areas identified for improvement in infection control audits.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Aspatria Medical Group on 10 November 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Risks to patients were assessed and well managed.
• Significant events were recorded, investigated and learned from.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
• Staff throughout the practice worked well together as a team.

We saw an area of outstanding practice:

• The practice had carried out an audit on medication which is used to treat anxiety and insomnia. The audit significantly reduced the number of patients prescribed this medication by 79%. The audit was used as the methodology for the clinical commissioning group (CCG) area to reduce the number of patients taking this medication. Following its success the pilot was rolled out nationally and a quote from a patient at the practice was used for a national information leaflet giving advice about inappropriate medication.

The areas where the provider should make improvements are:

• Consider revisiting the actions from significant events to ensure change had happened or been sustained.

• Carry out regular infection control and hand hygiene audits.

• Follow up actions identified in the legionella risk assessment with the landlord of the building.

• Implement a comprehensive checking schedule of single use items which are part of the equipment used in an emergency.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of our inspection we found that the practice was clean and free from odours. The main surgery waiting room was set up in such a way to give a patient as much confidentiality as possible when talking to staff at reception. Results from the patient satisfaction survey showed that the practice scored higher (better) than the national average score for GP practices for all questions answered. The practice had an active patient participation group. When we spoke with patients they told us, “I am always able to see the doctor of my choice. I am never rushed and they explain everything to me.” Another told us, “My treatment options were discussed today and we came to a joint decision about my medication plan. I understood fully why and what was happening and what to do if there were any problems.”

In speaking with the GP’s one told us, “The practice has worked very hard on the patient experience and adherence to standards.” Another told us, “The merging of the practices has increased overall expertise in certain clinical areas which has increased choice.” Evidence was available to support that staff had undertaken mandatory and or workplace appropriate training. Learning and development opportunities for nurses, reception and administrative staff were supported. One member of staff told us, “I think there is a very open culture here and good communication in the practice.” In the practices clinical governance plan for 2012 – 2013 we saw a framework for working to continually improve the quality of the care and service the practice provided. This plan included information on the management of incidents, the handling of complaints, managing infection control and an audit strategy.