Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Garden Surgery on 5 April 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• Patients said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• Longer appointments were given to those patients who needed them.
• Information regarding the services provided by the practice was available for patients.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• There was a complaints policy and clear information available for patients who wished to make a complaint.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.
• Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.
• The practice was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)
• There was a culture of openness and honesty, which was reflected in the approach to safety. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• There was a clear leadership structure and a stable workforce in place. Staff were aware of their roles and responsibilities and told us the GPs and manager were accessible and supportive.
• The practice ethos was to deliver good quality patient-centred care.

We saw two areas of outstanding practice:

• The practice employed their own pharmacist to assist with medication reviews, medicine optimisation and audits.
• The practice contracted the services of an independent consultant who periodically reviewed clinical performance data and reports to support improvements in service delivery and patient care

However, there was one area where the provider should make an improvement:

• The practice needs to reduce the probability of accidental interruption of the electrical supply to vaccine fridges. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We spoke with three patients about the service and nine staff at the Garden Surgery Medical Practice. Patients told us that they felt their health needs had been met by a very welcoming and friendly team who were competent to do their jobs.

Patient's needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person told us “Doctors here are brilliant” and “They make me feel so at ease and easy to talk to, she takes time to listen and nothing is too much trouble, she is a great doctor.” Another person told us “I am not rushed out of door before finished speaking.”

All staff had received training in protection of vulnerable adults and children. The training records we viewed confirmed all staff had received safeguarding training.

The provider had carried out monitoring of chronic conditions, how the practice was organised, how patients viewed their experiences and the extra services provided. This monitoring is required as part of Quality Outcomes Framework (QOF). This is an annual award and incentive programme that details the achievement results. The provider told us they were meeting most of the targets and we saw evidence of this.

We reviewed the information available to us about The Garden Surgery on 16 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.