Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection on 18 March 2015. Overall the practice was rated as good with requires improvement for the safe domain. Following that inspection we issued a requirement notice. This notice was due to a breach of Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment. The requirement notice was for the practice to implement the necessary changes to ensure patients who used the service were protected. A copy of the report detailing our findings can be found at www.cqc.org.

Our previous key findings across the areas we had inspected that needed to improve were as follows:

The provider must:

• To ensure all aspects of infection control are maintained. The provider must ensure there are suitable arrangements in place for the management of clinical waste and ensure all areas of the practice are maintained in a way to reduce the risk of cross infection. In addition they must ensure there are suitable arrangements for the safe handling of and management of bodily fluids taken as specimens.

• And:

The provider should:

• Carry out a patient specific fire safety risk assessment.

At this previous comprehensive inspection in March 2015 we had also noted that there were gaps in the prescription paper management at the practice and that the practice did not have a sufficiently detailed business continuity plan.

At this focussed, announced inspection in June 2016 we found that improvements had been made, the provider had implemented their actions and our findings were as follows:

• Safe systems were now in place for the safe management of infection control, the management of clinical waste and the safe handling and management of bodily fluids taken as specimens.

• Changes had been put in place for prescription management security and fire safety assessments were now in place at the practice. It is the provider’s responsibility to ensure these changes are sustained.

The provider should:

• The provider should ensure that the new system of prescription paper security is sustained.

• The practice should ensure that the patient specific fire safety risk assessment is regularly reviewed and updated when required.

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 Southmead and Henbury Family practice on 18 March 2015. Overall the practice is rated as good.

The practice comprises of two surgeries, one at Southmead Health Centre and the other in nearby Henbury at the Willow Tree Surgery. These are registered separately with the Care Quality Commission. As part of the inspection we visited both locations. This report reflects our findings for the Southmead Health Centre. Our findings for the Willow Tree Surgery are reported separately.

Specifically we found the practice to be rated as good for providing safe, effective, caring, responsive and well led services.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses that were recorded and reviewed.
• Risks to patients were assessed and well managed except in relation to some aspects of infection control and fire safety.
• Patients’ needs were assessed and care was planned and delivered following national guidance. Staff received training appropriate to their roles.
• Patients said they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment.
• Information about services and how to complain was available in the practice and on the practice website. Complaints were treated seriously and learning was shared with the staff team.
• Patients said it was easy to make an appointment and there was continuity of care.
• The practice was well equipped to meet patients’ needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice actively sought feedback from patients, which it acted upon.

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

Importantly the provider must:

To ensure all aspects of infection control are maintained the provider must ensure there are suitable arrangements in place for the management of clinical waste and ensure all areas of the practice are maintained in a way to reduce the risk of cross infection. In addition they must ensure there are suitable arrangements for the safe handling of and management of bodily fluids taken as specimens.

The provider should:

• Carry out a patient specific fire safety risk assessment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating June 2016 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive at Southmead Health Centre on 6 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

At this inspection we found:

• The practice had invested in a highly skilled nursing team who were working to address health inequalities within the patient community. We saw an innovative project to address the high prevalence of diabetes which had improved outcomes for patients. However long-term condition management achievement was lower than the local and national averages.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice had a good programme of ensuring that childhood immunisations courses were completed to provide full immunity. However they had not achieved the 90% coverage across the range of immunisations.
• Feedback from other health professionals and services demonstrated that the practice worked well with them and provided support in the interest of the best outcomes for patients. Patients could access assessment and treatment locally instead to the need to travel to other locations.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• There was a mutually supportive team of staff working well together with the aim of the best outcomes for patients.
• Staff were given the opportunity for professional development.

The areas where the provider should make improvements are:

• continue with developing an oversight of staff’s immunisation status.
• continue to monitor that the changes implemented for safeguarding adults training and disclosure and barring checks are sustained.
• continue to monitor and improve the uptake of health screening to meet Public Health England cancer screening targets
• to review and appropriately reduce exception reporting for patients with long term conditions
• improve uptake of childhood immunisations to a level required for herd immunity

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the report and the evidence tables for further information.