This practice is rated as Good overall. (Previous rating July 2015 – 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? – Requires Improvement

We carried out an announced comprehensive inspection at The Homewell.Curlew Practice on 7 June 2018 as part of our inspection programme.

At this inspection we found:

• The practice had introduced a hub access service for patients. The hub offered advice to non-urgent queries, arranged appointments and was supported by a nurse practitioner daily.
• The practice had recently recruited a reception manager to oversee the running of the reception area and team of receptionists.
• The locum pack used by the practice did not contain any information on safeguarding procedures or how to make referrals.
• All staff currently employed by the practice had undertaken safeguarding training but the practice did not provide evidence of what level of training any staff member had received.
• The practice’s uptake for cervical screening was below the national target rate of 80%.
• 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.
• Staff involved and 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.
• 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:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

The areas where the provider should make improvements are:

• To review the contents of the locum pack to include details on safeguarding processes.
• Continue to review and act on patient feedback in relation to access.
• To review how verbal consent is consistently recorded in patient records.
• To address the practice’s uptake of cervical screening

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

We carried out an announced comprehensive inspection at The Homewell.Curlew practice on 2nd July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. The practice is also rated as good for the six population groups which are older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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.
• The practice had recently merged and involved patient groups to minimise disruption to care.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with people who used the service, their relatives, GPs, administration, clinical staff and managers. We found the service to be welcoming with friendly staff.

We saw that on arrival at the service people could speak to reception staff or use the touch in booking screen. People told us staff treated them respectfully and were helpful. One person told us: "I never feel disrespected or patronised."

People told us that their treatment was clearly explained to them and they were able to ask questions and make choices about their treatment. This enabled people to make informed decisions about their treatment. One person told us, “Treatment options are explained to me; due to my condition my partner accompanies me”. Another said, “You are given the opportunity to ask any questions”.

Staff spoke politely to people and consultations were carried out in private treatment rooms. Information was available for people which included health promotion, access to support services and information about the practice and the services it provided.

Care and treatment was delivered in a way that ensured people’s needs were met. People we spoke with were very positive about their experiences of care and treatment at the practice. Comments made included, "Practice is good” and “Receptionists are really helpful”.

Policy and procedures were in place for reporting concerns in relation to both adult and child protection. Staff had received training in safeguarding children and vulnerable adults. People we spoke with confirmed that they were treated well and felt safe.

People said they felt that there were enough staff and that they had the right skills and experience to meet their needs. One told us, “Service now is fantastic, GP’s lovely, they have time for you. 100% friendly and it is really good to have the same day clinic”.

There were formal mechanisms and documentation in place to indicate the practice was able to monitor or assure the quality of the service people received.

We reviewed the information available to us about The Homewell.Curlew Practice on 8 June 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.