Letter from the Chief Inspector of General Practice

Carden Surgery was previously inspected on 25 August 2015 and was rated as good overall and for safe, effective, caring, responsive and well-led services.

At this inspection on 1 December 2017 the practice is rated as good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) – Good

At this inspection we found:

• The practice had clear 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 said they were able to book an appointment that suited their needs. Pre-bookable, on the day appointments, home visits and phone consultation services were available. Urgent appointments for those with enhanced needs were also provided the same day.

• There was an active patient participation group in place who told us that they had seen improvements within the practice.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice worked closely with other services in order to provide and improve care for their patient populations.

• Staff were positive about working in the practice and were involved in planning and decision making.

• Patient survey results were positive and higher than average in a number of areas.

We saw one area of outstanding practice:

• The practice encouraged registration and engagement for patients from a local travellers’ site by registering patients permanently rather than as temporary residents. The practice also offered help to complete registration forms and prescription requests. The practice told us this had helped to increase engagement and health awareness within this community. For example, there was an improvement in the number of patients within this community attending for immunisations, chronic disease reviews and health screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Carden Surgery on 25 August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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. Complaints were responded to appropriately and opportunities to learn and improve practice were taken.
• Patients said they found it easy to make an appointment with a GP and that there was continuity of care, 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The practice had begun to offer family planning and minor surgery but had not applied to have these activities added to their Care Quality Commission registration. However, they completed the initial application on the day of our inspection.

The provider should;

· Follow through on their application to add family planning and minor surgery to their regulated activities.

· Ensure medicine cupboards within the locked treatment room are also locked.

· Continue to take action to develop the patient participation group.

· Ensure records of cleaning of clinical equipment are in line with the practice infection control policy and that a schedule is maintained.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice