Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr AP Blight & Partners (also known as Ashfield Surgery) on 25 August 2016. The overall rating for the practice was good; however, the practice was rated as requires improvement for providing well-led services. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr AP Blight & Partners on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 20 November 2017 to confirm that the practice had carried out their plan to make improvements in relation to prevention and control of infections, encouraging the uptake of health checks and improving support available for non-clinical staff that we identified in our previous inspection on 25 August 2016.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice continues to be rated as good.

Our key findings were as follows:

• Infection Prevention and Control (IPC) procedures had improved since our previous inspection. Documentations provided by the practice showed that cleaning schedules were being completed which provided clear evidence that specific cleaning tasks relating to the clinical rooms had been carried out.

• Data from the 2016/17 Quality Outcomes Framework (QOF) showed improvement in the completion of various health checks. For example, since our previous inspection the number of patients diagnosed with dementia who had their care reviewed in a face-to-face consultation had increased from 63% to 85%, and was comparable to the Clinical Commissioning Group (CCG) average of 85% and national average of 84%. Members of the management team explained that since our previous inspection the practice had improved the clinical system template to ensure more accurate recording for dementia reviews.

• The practice continued working with other health care professionals in the case management of vulnerable patients. Since our previous inspection, the practice improved the accuracy of their clinical records. Data provided by the practice showed that the number of patients on the practice learning disability register had reduced from 55 to 50 patients as of the 31/03/2017. Unverified data provided by the practice showed an increase in the number of annual learning disability health checks from 22 to 38 patients, (demonstrating an increase from 40% to 76%). Staff explained that they targeted patients during their annual Flu campaign to increase uptake. The practice also commenced dedicated GP time for more structured clinics which focused on this population group. Staff continued writing and calling patients inviting them in for their annual health check.

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 Dr AP Blight & Partners (also known as Ashfield Surgery) on 25 August 2016. The overall rating for the practice was good; however, the practice was rated as requires improvement for providing well-led services. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr AP Blight & Partners on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 20 November 2017 to confirm that the practice had carried out their plan to make improvements in relation to prevention and control of infections, encouraging the uptake of health checks and improving support available for non-clinical staff that we identified in our previous inspection on 25 August 2016.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice continues to be rated as good.

Our key findings were as follows:

• Infection Prevention and Control (IPC) procedures had improved since our previous inspection. Documentations provided by the practice showed that cleaning schedules were being completed which provided clear evidence that specific cleaning tasks relating to the clinical rooms had been carried out.

• Data from the 2016/17 Quality Outcomes Framework (QOF) showed improvement in the completion of various health checks. For example, since our previous inspection the number of patients diagnosed with dementia who had their care reviewed in a face-to-face consultation had increased from 63% to 85%, and was comparable to the Clinical Commissioning Group (CCG) average of 85% and national average of 84%. Members of the management team explained that since our previous inspection the practice had improved the clinical system template to ensure more accurate recording for dementia reviews.

• The practice continued working with other health care professionals in the case management of vulnerable patients. Since our previous inspection, the practice improved the accuracy of their clinical records. Data provided by the practice showed that the number of patients on the practice learning disability register had reduced from 55 to 50 patients as of the 31/03/2017. Unverified data provided by the practice showed an increase in the number of annual learning disability health checks from 22 to 38 patients, (demonstrating an increase from 40% to 76%). Staff explained that they targeted patients during their annual Flu campaign to increase uptake. The practice also commenced dedicated GP time for more structured clinics which focused on this population group. Staff continued writing and calling patients inviting them in for their annual health check.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of the inspection we spoke with one staff member, the practice manager, a GP and a practice nurse manager. We also spoke with seven patients who had arrived for their appointments. All the patients we spoke with were generally positive about the experiences of care they had received at the surgery. Some patients commented that it was difficult to get an appointment but were able to see a GP if it was an emergency. Some patients also commented that they often had to wait longer after their appointment time for a GP of their choice because that GP was more popular.

We found that care and treatment was planned and delivered in a way that met patients’ needs. Patients we spoke with told us they were happy with the level of care they had received.

Appropriate guidance was available for staff to follow if abuse was suspected. However, some staff had not received training in safeguarding adults and we did not see evidence of background checks for a practice nurse.

Appraisals for staff had not been carried out for a number of years but plans were underway to ensure they were being carried out.

The practice carried out a range of audits to monitor the quality of the service. This ensured that on-going improvements could be made.