We carried out an announced comprehensive inspection at South Reading Surgery on 13 September 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the September 2017 inspection can be found by selecting the ‘all reports’ link for South Reading Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 March 2018 to confirm that 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 13 September 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• There was an appropriate system in place to respond to complaints and share learning arising from complaints.

• There was an effective system in place for keeping emergency equipment and medicines needed for medical emergencies. Both equipment and medicines were regularly checked.

• Staff received training appropriate to their roles.

• The practice had an action plan underway to improve access to the practice by telephone and to appointments. Whilst the actions identified were underway it was too early to evaluate whether they would be effective in improving access to the service.

• Staffing structures had been reviewed and recruitment campaigns launched to increase clinical staffing levels. Two part time practice nurses and a clinical pharmacist had been recruited.

• Staff were involved in the management of the practice via a weekly team meeting attended by team leaders and the partners.

• The practice had responded to an incident when water supply to part of the premises had been interrupted. A proposal to alter the business continuity plan had been recorded for agreement by the partners.

  However, there were also areas of practice where the provider needs to make improvements.

  Importantly, the provider should:

• Monitor implementation of their action plan and evaluate whether actions taken to improve access are effective.

At our previous inspection on 13 September 2017, we rated the practice as requires improvement for providing responsive services because feedback from patients was poor in regard to accessing the practice by telephone and obtaining appointments. At this inspection we found that the practice had clear plans in place to address patient feedback. However, the plan had commenced and there was further work to be undertaken. It was too early to evaluate if the plan would improve access. Consequently, the practice is still rated as requires improvement for providing responsive services.

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 South Reading Surgery on 11 January 2017. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for South Reading Surgery on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 13 September 2017. The practice is rated as good for safe, caring and effective services and requires improvement for responsive and well led services. Overall the practice is now rated as requires improvement.

Our key findings at the September 2017 inspection were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed, with the exception of those relating to prescription security, emergency medicine provision and patient group directions.
• 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.
• There was not an effective system for ensuring all referrals under the two week wait system, for potential cancer diagnosis, were reviewed and an appointment made.
• The majority of patients were positive about their interactions with staff and said they were treated with compassion and dignity.
• Results from the latest GP national patient survey were poor for several areas of care.
• The practice had reviewed the organisational structure and delegated responsible individuals into key roles. Staff told us communication links between staff and management had improved.
• Governance arrangements had not identified some risks, but these were quickly rectified on the day of the inspection.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• Ensure all blank prescriptions are suitably recorded and their use tracked through the practice.
• Ensure that the practice engages with patients whilst increasing awareness of the NHS Friends and Family Test to determine appropriate action with a view to monitor the patient experience.
• Ensure a detailed action plan is in place to respond to poor patient feedback from the GP national survey.
• Ensure any changes to emergency medicines provision is risk assessed and discussed.

I am taking this service out of special measures. This recognises the improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice