Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oldfield Surgery on 16 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• The provider should ensure the new protocol and logging system they had implemented to reduce the potential of prescription paper misuse is sustained.
• The practice should develop and implement an overall practice policy and audit process for the medicines kept in GPs bags used on home visits.
• The practice, even when they have been checked, should retain copies of proof of identity for new employees.
• The practice should ensure documentary evidence is kept to show that an overall health and safety risk assessment process had been carried out on both practice locations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People who use the service were given appropriate information and support regarding their care or treatment. On arrival at the surgery we saw there was a variety of information on display in the waiting area. This included health promotion leaflets and information about the services available at the surgery which included a range of alternative therapies.

We spoke with five patients who attended the surgery on the day of our inspection. They told us they were happy with the service. Comments included “its brilliant here, absolutely fantastic” and “staff are very respectful and always explain things well”.

We found staff were knowledgeable and experienced at referring people into secondary care such as hospital consultants or specialist services. People we met said when they had been referred the transfer of care was made effectively to the right person or department. We were told by people and staff the practice used the NHS Choose and Book system to ensure people had choice about where and when they were referred for surgery.

We saw the practice had safeguarding policies in place for both children and vulnerable adults. These were up to date and included contact details and flow charts of how to contact the local authority to make a referral. There were identified lead clinician’s with a clear role to oversee both safeguarding adults or children within the practice.

GPs and nurses were subject to a satisfactory Disclosure and Barring Service (DBS) check. This is a check to see if the person's has a criminal record. We were shown the up to date schedule of all staff DBS checks which the practice kept.

We saw evidence the practice also checked and maintained proof of a person’s qualifications or registration with the appropriate professional body. For example, a copy of General medical Council (GMC) registration or Nursing and Midwifery (NMC) registration and qualifications.

All of the patients we spoke with told us they never had any reason to complain but told us they would speak to the practice manager if needed. They also told us they believed if they made a complaint it would be dealt with appropriately. This meant patients had confidence their complaints would be fully investigated and resolved, where possible, to their satisfaction.