Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Croston Village Surgery on 1 December 2016.

Overall the practice is rated as good.

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

• There were systems in place to reduce risks to patient safety, for example, equipment was checked to ensure it was safe to use and there were sufficient numbers of staff to meet the needs of patients.

• Staff understood their responsibilities to raise concerns and report incidents and near misses. Staff spoken with knew how to identify and report safeguarding concerns.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff told us they felt well supported. Overall, they received an annual appraisal and had access to the training they needed for their roles.

• Patients were positive about the care and treatment they received from the practice. The National Patient Survey July 2016 showed patients’ responses about being treated with respect, compassion and involved in decisions about their care and treatment were either, comparable or above local and national averages.

• Services were planned and delivered to take into account the needs of different patient groups.

• The National GP Patient Survey results showed that patient’s satisfaction with access to care and treatment was above local and national averages.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

We saw areas of outstanding practice:

• The practice demonstrated how it cared for patients. Following flooding of the village in 2015 the practice hosted services to support patients such as a food distribution service and a counsellor. The clinical staff also checked on the welfare of patients during the floods and continued to visit patients who had moved out of the village due to the flooding. The practice won the Practice Team of the Year Award from the Royal College of General Practitioners in recognition of the team effort to aid patients during the floods. The practice manager had appeared on the television to help promote awareness of coeliac disease. The village had also entered the Royal Horticulture Society Britain in Bloom competition and the practice had encouraged patients, in particular isolated patients to help. The village won the Gold Award which was an achievement for the patients, practice and community.

• The National GP Patient Survey showed that a number of patient responses about access to the service were above local and national averages. For example, 94% of patients were satisfied with the practice’s opening hours compared to the CCG average of 79% and national average of 76%. One hundred percent of patients found it easy to get through to the practice by phone compared to the CCG average of 71% and national average of 73% and 93% of patients feel they don't normally have to wait too long to be seen compared to the CCG average of 65% and the national average of 58%.

The areas where the provider should make improvements are:

• The practice should review its procedures and staff training to ensure that the systems for identifying and reporting significant events are robust and there is a system to record the action taken following receipt of patient safety alerts.

• Review the management of vaccine fridges to ensure staff are adhering to the protocol for the safe management of vaccines.
• A second thermometer should be used to monitor fridge temperatures and the lead to one fridge should be made safer to guard against the plug being accidentally disconnected from the electricity supply.
• Staff recruitment records should contain evidence of information having been gathered about any physical or mental conditions which were relevant (after reasonable adjustments) to the role the person was being employed to undertake.
• Health and safety risk assessments of the premises should be documented.
• A record should be made of all meetings to demonstrate that important information such as actions from significant events has been shared.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People expressed satisfaction with the practice and explained how they were involved in making decisions about the treatment they received. People were given suitable information to help them make such decisions. People told us they were treated with dignity and respect when they called or visited the practice.

We found there were appointments each day which were kept free for people who needed one at short notice. People said they never had any problem getting to see the doctor. People were confident the doctor understood their medical conditions and helped them with treatment that met their needs. The practice had made suitable provision for out of hour services and foreseeable emergencies. Staff were appropriately trained to deal with emergency situations.

Staff at the practice said they felt well supported by the manager. Staff were given opportunities for learning and development and given protected time to undertake such development.

We found not all staff at the practice had undergone training in safeguarding vulnerable adults and children. We judged this presented a risk to people as staff may not always be able to identify and report abuse or prevent potential abuse.

People were able to make suggestions and raise concerns about the practice. An annual satisfaction survey was conducted and a patient participation group provided a forum for people to discuss the practice. This helped the provider to monitor the quality of the service provide for people.

We reviewed the information available to us about Croston Village Surgery on 1 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.