Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Devon Square Surgery on Wednesday 12 August 2015. Overall the practice is rated as good.

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

• There was a safe track record and 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. Medicines were well managed and the practice had good facilities and was well equipped to treat patients and meet their needs
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• 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 found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• There were clear recruitment processes in place. Staff had received training appropriate to their roles and any further training needs had been identified and planned
• The practice was well organised and there was a clear leadership structure. The practice proactively sought feedback from staff and patients, which it acted on.

We saw two areas of outstanding practice for older patients and those identified as being frail:

• The practice had been instrumental in the development of a model in Newton Abbot named ‘1 care home, 1 practice’ . The model allocated a designated GP who cared for the majority of residents in a care home which meant the GP were able to offer regular review visits and develop strong relationships with the residents, managers and staff. Care home staff said this had improved communication between the GP and care home and had given patients reassurance that they knew the GP that visited them.

• The practice were also actively involved in the locality ‘8-8 initiative’, whereby local Newton Abbot GPs had been providing out of hours cover at nights and during the weekend for the top 2% most frail patients. The GPs had collaborated so that all the local GPs involved in this have access to the other practice’s computer records, meaning they provided a greater continuity of care and were more informed about the patients they were seeing. Anecdotal evidence was that this scheme had reduced hospital admissions. Formal data was being collated.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Provide evidence of a system to ensure that curtains in consulting rooms are cleaned or changed at least once every 6 months.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Devon Square surgery was inspected on Thursday 10 July 2014. This was a comprehensive inspection.

Devon Square Surgery provides primary medical services to patients living in Newton Abbot and the surrounding areas. The practice is in Newton Abbot. At the time of our inspection there were 8,520 patients registered at the practice.

There was a team of seven GPs meeting patients’ needs. Five GPs were partners, meaning they held managerial and financial responsibility for running the practice. In addition there were three registered nurses, and three health care assistants.

Patients who used the practice had access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, speech therapists, counsellors, podiatrists and midwives.

Our key findings were as follows:

Patients spoke very positively about the staff employed at the practice and the level of care they received. Patients told us they felt that the practice is safe. They told us that care was given to them in accordance with their wishes and opportunities were given for informed decision making. Patients told us they felt the practice was responsive to their needs. For example, patients said that an urgent appointment could always be obtained on the day they contacted the practice and they could usually see their named GP for non-urgent visits or speak to a GP by telephone. This was reflective of the information provided on the practice website and within the practice welcome pack.

Patients told us about their experiences of the practice. Responses from 10 patients we spoke to on the day, from the two comment cards left for us and within the practice’s own patient survey involving 101 patients in February 2014, were very positive. Views of external stakeholders were very positive and aligned with our findings.

There was evidence that learning from incidents, significant events and investigations took place and appropriate changes are implemented to improve the practice and patient experiences.

The practice was managed well, with a clear leadership structure in operation. The staff we spoke with spoke positively about the management within the practice and told us they felt supported in their roles. Supporting information reviewed during our inspection demonstrated the practice had appropriate systems in place that regularly monitored the safety and effectiveness of the care provided.

Recruitment, pre-employment checks, induction and appraisal processes were robust. Staff had received training appropriate to their roles and further training needs had been identified and planned.

Documentation about the practice demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area.

Patients felt safe in the hands of the staff and felt confident in clinical decisions made. There were effective safeguarding procedures in place.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Consider storing records of the audits centrally to provide a resource for students, trainees and staff at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We reviewed the information available to us about Devon Square Surgery on 29 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.