This practice is rated as Good overall. (Previous inspection 14 April 2015– rated as Good overall)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Mere Lane Group Practice on 28 March 2018 as part of our routine inspection programme.

At this inspection we found:

• The practice had experienced difficulties with staffing over the past two years, including the loss of three GPs and their nursing team due to various reasons. The practice was now under a changed partnership and despite several setbacks had maintained the quality of care for patients and the safety of the practice. They had managed to secure two new partners, a new practice manager and nursing team.
• The practice recognised that their performance had suffered in terms of contractual performance targets and patient satisfaction with appointments because of the upheaval in change of staff structure. The practice was addressing this situation and had a set of strategic plans to improve.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• 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.
• Care Quality Commission (CQC) comment cards reviewed indicated that 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Results from the national GP patient survey from July 2017 showed that patients’ satisfaction with how they could access care and treatment was lower than local and national averages. The practice was aware of the results and had redesigned the appointment system. Urgent appointments were available the same day.
• There was a clear leadership structure and staff felt supported by management. The practice had recently achieved a Health and Wellbeing award. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware and acted on the requirements of the duty of candour.

We saw areas of outstanding practice:

• The practice had a recall system for health reviews managed by a dedicated administrator who ensured that patients’ alcohol status and smoking status were recorded during the phone call to make the appointment as opposed to during the consultation.
• The practice had carried out a review of its safeguarding practices and appointed the clinical practitioner as the deputy safeguarding lead who had two sessions a month dedicated to reviewing all safeguarding cases and updating any registers.

The areas where the provider should make improvements are:

• Maintain the overview and plans in place to improve on their quality outcomes framework results (QOF).

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 Mere Lane Group Practice on 14 April 2015. Overall the practice is rated as good.

Mere Lane Group Practice provided safe, effective, responsive care that was well led and addressed the needs of the population it served.

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

• Systems were in place to ensure incidents and significant events were identified, investigated and reported. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons learnt from the investigation of safety incidents were disseminated to staff. Infection risks and medicines were managed safely.

• People’s needs were assessed and care was planned and delivered in line with current legislation and guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned. Patients experienced clinical outcomes that were in line with or above the national average. The practice used innovative and proactive methods to improve patient outcomes, working with the CCG and other local providers. For example the OWLS project (Older Wiser Living Socially).

• Patients spoke highly of the practice. They said they were treated with care, compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice provided care to its population that was responsive to their health needs. Patients were listened to and feedback was acted upon. Complaints were managed appropriately.

• There was a clear leadership structure, staff enjoyed working for the practice and felt well supported and valued. The practice monitored, evaluated and improved services. The practice proactively sought feedback from staff and patients, which it acted on.

There was an area of practice where the provider needs to make improvements.

The provider should:

• Improve access to GP appointments by reviewing the telephone system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice