This practice is rated as Good overall. At the previous inspection in August 2015, the practice was rated as Outstanding overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Firs House Partnership on 18 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We concluded that:

• Patients were able to access care and treatment in a timely way.
• Quality Outcomes Framework data was generally in line, or above, local and national averages. However, exception reporting data was higher than both the CCG and England averages in indicators such as mental health.
• Feedback from patients was positive about the practice, including the staff team.
• Members of staff we spoke with were positive about working at the practice and the support provided by the leadership team.
• The practice worked closely with the local community and implemented a number of activities to support the population and provide health and lifestyle advice.
• The practice worked effectively with their Patient Participation Group (PPG) and undertook a number of engagement activities.

At the previous inspection in August 2015 the practice was rated as Outstanding for providing responsive and well led services. At this inspection we have rated the practice as good for providing responsive and well led services as we found the practice had sustained these areas but had not further improved and developed them. These services that had been identified as outstanding services have been adopted as good practice across the wider primary care system.

The areas where the provider should make improvements are:

• Review and improve the management of sharps waste management.
• Continue to review and improve the exception reporting rate for QOF mental health indicators where appropriate.
• Review and improve the process for handling safety alerts to ensure all actions are recorded.
• Review and improve the number of learning disability health checks provided.
• Review and improve the practice’s performance in childhood immunisations.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Firs House on 30 June 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing responsive and for being well led. It was also outstanding for providing services for the elderly, people with long term conditions, families, working age people, people who's conditions may make them vulnerable and people experiencing poor mental health . It was good for providing caring, effective and safe services.

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

• Staff understood and fulfilled their responsibilities to raise concerns, report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the practice had developed an intranet that communicated with staff. This shared a large amount of clinical and organisational data and had been adopted by other providers in the Clinical Commissioning Group (CCG).
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice offered a wide range of specialised clinics and the practice had reached out to the local community by approaching community events, churches, schools and had attended them to promote better health. If any underlying health issues were identified the patients were offered an appointment at the practice and patients from other practices were advised to attend their own GP.
• The practice had identified 500 patients where there were clinical indications to offer medication to reduce cholesterol. They carried out a clinical trial offering these patients extended appointments to explain the benefits and risks from that medication. The results of this trial are awaiting publication.
• The practice has an extremely engaged and active patient participation group (PPG) with over 800 members participating remotely, as well as regular face to face engagement. We saw examples of the PPG being able to influence practice behaviour to benefit patients and organise health promotion events.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice