Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mowbray House Surgery 30 November 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice promoted a no blame culture and encouraged staff to raise concerns and possible risks.

• 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. Improvements were made to the quality of care as a result of complaints and concerns. When a complaint related to any aspect of clinical work it was raised as a significant event.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day and pre bookable appointments available.

• Feedback from patients about their care was consistently positive.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure in place. The practice proactively sought feedback from staff and patients, which it acted on. The provider was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

We saw several areas of outstanding practice:

• The practice had developed an acute care team which included paramedics employed by the practice responding to acute care needs and requests for home visits.

• The practice had developed a range of patient leaflets to inform patients prescribed certain medicines such as anti-inflammatory medicines, diuretics and diabetes medicines what they should do if they become unwell with conditions such as diarrhoea and vomiting. The administration staff had created a clinical software tool which prompted the prescriber to offer a ‘sick day rules’ leaflet to the patient.

The practice SHOULD:

• Implement expiry date checking of medicines at Mowbray House.

• Follow standard operating procedures in relation to cold chain storage to ensure compliance with national guidelines.

• Manage Patient Specific Directions in line with national guidance.

• Patient’s records are appropriately updated after review has taken place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

When the provider initially registered with the CQC in December 2012 they declared they were non-compliant in two areas: safeguarding people who use services from abuse and cleanliness and infection control. We reviewed these areas at this inspection and found compliance in all areas to the regulations.

We spoke with patients, in private, who visited the surgery on the day of our inspection. We spoke with GPs, the practice manager and other team members too.

Patients told us they were very happy with the care and support they received from this practice. Some people said they were happy to see any doctor or nurse as "They are very, very good.” Another told us "They talk to you like they want you to understand. They don’t talk down to you.” This meant patients felt their views about their care and treatment were listened to and their needs were met.

We found patients were protected from the risk of abuse.

We saw that there were effective systems in place to reduce the risk and spread of infection.

We found that patients were cared for by staff who received appropriate professional development.

Patients told us that they had not had any need to complain; but if necessary they would speak immediately to either the doctor or the practice manager.