Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Brooke Surgery on 8 July 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the impact of the work carried out by the well-being champion, healthy living project and ward rounds within residential and nursing homes.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Data showed patient outcomes were in line with or above those locally and nationally.
• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients. This included significant renovation of the reception and waiting areas.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment and that 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.

We saw areas of outstanding practice, including:

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The nurse practitioner or GPs carried out weekly ward rounds at a residential home. Outcomes showed 61% reduction in unplanned hospital admissions and improved communication with staff at the practice and nursing homes.

The areas where the provider should make improvement are:

• We noted two nursing rooms were carpeted. This had not been risk assessed as part of the infection control audit.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The Brooke Surgery provides primary medical services in Hyde town centre Monday to Friday between the hours of 8am and 6pm, with the exception of Thursday when the surgery remains open until 9pm. Patients can make an appointment on line, by calling into the surgery or by telephone.

As part of our inspection we spoke with patients and reviewed information we received from comment cards. We also reviewed information from patient surveys and comments that patients had left on the NHS choices website.

Patients told us they were happy with the care and treatment they receive, though expressed some frustration about difficulties they experience trying to make an appointment. Despite this patients told us that they were always seen in an emergency.

We saw the practice was clean and hygienic , with systems in place to ensure the safety of patients, including infection control. We found medicines management was safe.

We found that the surgery was suitably staffed and staff were trained and competent to perform their roles. However staff had not completed training in the Mental Capacity Act 2005, or the Deprivation of liberties safeguarding training.

We found the service was effective in meeting the needs of patients and working effectively with other health and social care professionals.

We inspected the following regulated activities:

• Diagnostic and screening procedures
• Family planning
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury