Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Reedyford Health Care on 14 April 2016. Overall the practice is rated as good.

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

• The practice sought out innovative methods to share health information and health promotion campaigns through Facebook and Twitter.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients were able to get urgent appointments but said they sometimes found it difficult to make an appointment with a named GP. The practice was actively trying to address patient access.
• 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 practice offered drop in sexual health clinics and childhood vaccinations outside the core working day.
• The practice identified that not all external test results were being recorded on patient medical notes during the inspection, for two out of 151 patients who were prescribed warfarin. The practice began addressing this whilst we were on site.

We saw one area of outstanding practice:

The practice had begun using social media to communicate with patients and reached a wide audience through Facebook and Twitter. For example, The practice had 1,800 followers on Twitter and its Facebook page showed over 2,000 views in one week. A variety of health promotion campaigns were being shared with a large group of patients in this way. A cardiac rehabilitation video which explained the signs and symptoms of cardiac arrest had been shared, this had reached over 10,000 people through Facebook groups.

The areas where the provider should make improvement are:

• Review procedures to update patient medical records consistently with information from other providers, including clinical information and test results.
• Review access to emergency drugs to ensure these are easily accessible in an emergency and review the signage around the emergency oxygen in the reception area.
• Review access to complaints leaflets so patients can access these without requesting them from reception staff.
• Conduct annual significant event reviews to ensure all learning has been implemented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with six people who had attended for appointments, one GP, the practice manager, two reception staff and two nurses. We also spoke with a member of the Patient Participation Group (PPG).

People told us they were fully involved in discussions and decisions about their treatment and said they were listened to. One person said, "I can speak to the doctor and tell him what is wrong with me; he listens and asks me questions".

People told us they could request an appointment either by dropping into the practice, by telephone or on line. Comments included, "The appointment system is fast and flexible and I can usually see the doctor of my choice" and "I left a message this morning and they rang with an appointment for today".

The practice had clear policies and procedures in place for dealing with allegations of abuse. Records showed all staff had undertaken appropriate training in safeguarding. This would help staff to recognise and act when people were at risk of abuse or neglect.

There were effective systems in place to monitor the quality of service provision. We found people’s views had been taken into account in the way the service was provided.

People were happy with the staff team and with the service they received. Comments included, "All the staff are very nice" and "Everyone is polite and helpful". Staff told us they enjoyed working at the practice.