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Great Western Surgery, Swindon.

Great Western Surgery in Swindon is a Doctors/GP specialising in the provision of services relating to diagnostic and screening procedures, family planning services, maternity and midwifery services, services for everyone, surgical procedures and treatment of disease, disorder or injury. The last inspection date here was 13th December 2019

Great Western Surgery is managed by Carfax Health Enterprise Community Interest Company who are also responsible for 2 other locations

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Requires Improvement
Overall:

Further Details:

Important Dates:

    Last Inspection 2019-12-13
    Last Published 2018-08-24

Local Authority:

    Swindon

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

8th August 2017 - During a routine inspection pdf icon

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Western Surgery on 8 August 2017. Overall the practice is rated as requires improvement.

The current provider took over the practice in January 2017.

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

  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The provider had defined systems to minimise risks to patient safety. At the time of our inspection, the new provider was implementing their systems within the practice and therefore some processes had not been fully embedded.
  • Systems and processes to action safety alerts such as those from the Medicines and Healthcare products Regulatory Agency did not ensure all staff had received those alerts, and actions taken were not recorded.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. However, we found there were gaps in staff training and did not show if staff had received those training or required updates, for example, fire training, Mental Capacity Act training and safeguarding training.
  • Not all appropriate recruitment checks had been carried out for staff who had transferred to the current provider from the previous provider.
  • The vaccine fridge had not been calibrated since September 2015 and therefore, the provider could not be assured if the vaccine fridge was operating effectively.
  • Verbal complaints were not recorded and there were no evidence that learning from complaints had been shared with staff.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available.
  • Most patients we spoke with said they found it easy to make an appointment with a GP with urgent appointments available the same day. However, they also commented that they do not always see the same GP which did not contribute to continuity of care
  • Since taking over the practice, the provider had made a number of improvements to the premises and purchased new equipment to ensure these were fit for purpose.
  • 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 a number of policies and procedures to govern activity.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvement are:

  • Ensure care and treatment is provided in a safe way for patients.

  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

  • Ensure specified information is available regarding each person employed.

The areas where the provider should make improvement are:

  • Ensure the temperature of the vaccine fridge is consistently monitored and calibrated in line with the manufacturer’s instructions.

  • Continue to with their programme of reviews for patients with long-term conditions.

  • Ensure patients who have a learning disability have been encouraged to undertake an annual review of their health.

  • Ensure a cycle of re-audits are implemented to monitor patient outcomes.

  • Improve the system for the recording of complaints to ensure verbal complaints are captured and recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

1st January 1970 - During a routine inspection pdf icon

This practice is rated as Requires Improvement overall. (Previous inspection 8 August 2017 – Requires Improvement).

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection of Great Western Surgery on 8 August 2017. Overall the practice was rated as requires improvement. The comprehensive report for the August 2017 inspection can be found by selecting the ‘all reports’ link for Great Western Surgery on our website at www.cqc.org.uk.

Following the inspection on 8 August 2017, the provider sent us an action plan that set out the actions they would take to meet the breached regulations. We then carried out an announced follow-up comprehensive inspection of Great Western Surgery on 20 June 2018, to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 8 August 2017. This report covers the announced follow-up comprehensive inspection. We found that although the provider had made improvements since our inspection in 2017, these were not sufficient to meet regulations for safe and well-led services.

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 found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.
  • Great Western Surgery has responded to the needs of its patient group by making routine health appointments at least 15 minutes in duration.
  • Patients on multiple medicines attended the practice for a single review of all their medications needs.
  • There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality.
  • Great Western Surgery identified patients at risk of developing diabetes who were not on the diabetes register, and implemented changes that could help to prevent the progression of this health condition.

The areas where the provider must make improvements are:

  • The provider must ensure care and treatment is provided in a safe way to patients.
  • The provider must establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • The provider should continue to make efforts to increase the programme coverage of women eligible to be screened for cervical cancer and other indicators of patient outcomes.
  • The provider should ensure that clinical staff confirm the accuracy of computerised notes by cross-checking these with other records of consultations, and audit this process.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

 

 

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