This practice is rated as Good overall. (Previous rating October 2014 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at The Gainsborough Practice on 14 November 2018. We undertook this inspection as part of our inspection programme.

At this inspection we found:

• 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. However, not all incidents were reported using the practice’s own process.
• The practice had high exception reporting for some areas of patient care. They had not routinely reviewed the effectiveness of their recall processes, to ensure they engaged with patients appropriately and reduced the number of patients who failed to respond to invitations for reviews.
• Care and treatment was delivered according to evidence-based guidelines.
• Staff treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Complaints were well handled and in line with guidance. We noted there was no record of verbal complaints.
• Governance processes were established and embedded, although they were applied inconsistently. For example, the practice had not identified high exception reporting or considered the risk associated with patients not attending for review appointments.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.

The areas where the provider should make improvements are:

• Improve how staff identify events and incidents to be reported through the significant events pathway.
• Review staff training requirements and improve how training records are maintained.
• Consider how verbal complaints could be documented and included in complaints analysis.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

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

Letter from the Chief Inspector of General Practice

The Gainsborough practice is located in a purpose built medical centre on the outskirts of Bracknell in Berkshire. Approximately 10,000 patients are registered at the practice. We carried out an announced comprehensive inspection of the practice on 14 October 2014. This was the first inspection of the practice since registration with the CQC.

The practice was going through a period of transition. The appointments system had changed on 1 October with the introduction of a named GP for all patients to support continuity of care. The change had been made in response to patient feedback from earlier patient surveys. Patients who responded to satisfaction surveys had expressed a strong preference for continuity of care coupled with easier access to appointments. Two new partners had joined the practice in the last three years and another partner was retiring in December 2014.

We spoke with ten patients during the inspection. We met with two members of the patient participation group and spoke with three GPs and a range of practice staff.

Gainsborough practice was rated good overall.

Our key findings were as follows:

• the practice operated safe systems that enabled the identification, assessment and management of risk. Medicines were managed safely in a clean and well kept environment.
• GPs treated patients in accordance with national and local guidelines. Staff were trained and knowledgeable. The practice worked with other services to ensure patients with complex needs were cared for appropriately.
• patients told us and we observed that they were treated with care and compassion. Staff were careful to maintain confidentiality of patient information.
• the practice was undertaking a major change of appointment system to respond to patient feedback. Patients valued continuity of care and the practice was responding by introducing a named GP for every patient.
• the practice was well led. There was a clear vision and business plan and we found all staff committed to delivering patient centred care in a timely manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice