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

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at The Glebeland Surgery on 27 April 2018 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.

•The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.

•Staff involved and treated patients with compassion, kindness, dignity and respect. The practice scored higher than average scores in a number of areas of the national GP patient survey 2017.

•Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

•There was a strong focus on continuous learning and improvement at all levels of the organisation.

•There was a strong emphasis on the safety and well-being of all staff.

•Repeat prescriptions were not always produced and signed in accordance with Schedule 6 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 and paragraph 39(3) of Schedule 6 to the GMS Regulations.

The areas where the provider must make improvements are:

•Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

•Review their system for maintaining effective oversight of staff training.

•Review their system to identify and provide support to carers.

Please refer to the requirement notices section at the end of this report for more details.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of The Glebeland on 30 October 2014. We found that The Glebeland provided a good service to patients in all of the five key areas we looked at. This applied to patients across all age ranges and to patients with varied needs due to their health or social circumstances.

Our key findings were as follows:

• The practice had systems for monitoring and maintaining the safety of the practice and the care and treatment they provided to their patients.
• The practice was proactive in helping patients with long term conditions to manage their health and had arrangements in place to make sure their health was monitored regularly.
• The practice was clean and hygienic and had robust arrangements for reducing the risks from healthcare associated infections.
• Patients felt that they were treated with dignity and respect. They felt that their GP listened to them and treated them as individuals.
• The practice had a settled and well trained team with expertise and experience in a wide range of health conditions.
• The practice provided flexible and responsive services, (including a dispensary) in a rural area where there was limited public transport.
• The practice provided a caring and responsive service to a significant number of patients living in four local care homes and to pupils at a residential school.

There were areas where the practice needs to make improvements.

The practice should:

• Introduce a more comprehensive range of clinical audits to monitor and improve performance and contribute to staff learning.
• Develop their systems system for capturing, recording and learning from significant events to make these more comprehensive and robust.
• Ensure all GPs working at the practice have completed up to date safeguarding training.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Glebeland Surgery on 27 April 2018 as part of our inspection programme. The overall rating for the practice was Good. The full comprehensive report on the April 2018 inspection can be found on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 14 September 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation we identified in our previous inspection on 27 April 2018. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good.

At our previous inspection the areas where the provider needed to make improvements were:

• Ensure care and treatment is provided in a safe way to patients. The practice did not have a proper and safe system for the management of medicines. Prescriptions were not produced and signed in accordance with the relevant regulations.

The areas where the provider were advised to make improvements were:

• Review their system for maintaining effective oversight of staff training.
• Review their system to identify and provide support to carers.

During our desk-based review our key findings were as follows:

• The practice now had a proper and safe system for the management of medicines. Prescriptions were produced and signed in accordance with the relevant regulations.
• There was now a system in place for the effective oversight of staff training.
• There was a system in place to identify and provide support to carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice