We carried out an announced comprehensive inspection at Bursted Wood Surgery on 21 July 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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they generally found it easy to make an appointment but that there was a lack of continuity of care due to the absence of permanent medical staff. Urgent consultations were 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• The provider should continue to make every effort to recruit permanent GP staff.

• The provider should review the management of long-term conditions to improve outcomes for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We did not speak to patients during this inspection. We carried out this inspection to ensure that the provider had completed the required improvements and addressed the areas of non compliance found at our inspection on the 08 May 2014.

At the inspection on the 29 July 2014 we found that the provider had made the required improvements in order to protect people from the risk of infection and ensure that the correct recruitment procedures were followed.

We did not speak with patients during this inspection. We carried out this inspection to determine if the provider had taken action to address the areas where we found non compliance during our last inspection in August 2013.

Our last inspection of 07 August 2013 found that there were improvements required in the arrangements to protect people from the risk of infection, and in staff recruitment. During this inspection we found that the provider had taken some actions to address these issues, but there was further work required in these areas.

People we spoke with were generally happy with the treatment they received from the surgery. One person told us "I’ve been a patient for 20 years and I can always get an appointment” and another described the care they received as "very good". We found that most people felt listened to by the GPs and other staff at the practice. A few people said they had difficulty getting through on the telephone or getting an appointment. Some people also felt that there had been a number of new GP’s over the last few years that they would prefer to have the same GP and there was a lack of consistency. Most people felt they were treated with respect by all staff and that the GP’s and nurses listened to them. People felt that personal issues were handled confidentially and the receptionist were all very discreet and never asked personal questions.

We found that the majority of people were consulted with and involved in their care and provided with an explanation about their condition or illness. People's needs were assessed and care was planned in a way that met these needs. There were procedures in place and most staff had been trained in both child and adult safeguarding procedures. The practice had systems in place to the safety of the premises and ensure the quality of the service was monitored. However, the practice had not taken adequate steps to ensure that only suitable people were employed at the surgery and that checks relating to infection control practices and training were carried out.