This practice is rated as Good overall.

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? - Good

We carried out an announced comprehensive inspection at The Old Exchange Surgery on 7 August 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.
• Arrangements for dispensing medicines at the practice kept patients safe.
• 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.
• Clinical audit had a positive impact on quality of care and outcomes for patients. There was clear evidence of action to change practice to improve quality.
• The practice’s performance in relation to the Quality Outcome Framework (QOF) results was generally in line with the Clinical Commissioning Group (CCG) and national averages.
• Staff encouraged and supported patients to be involved in monitoring and managing their own health, for example through social prescribing schemes.
• Results from the July 2017 national GP patient survey were generally above local and national averages.
• All 10 of the patient Care Quality Commission comment cards we received were positive about the service experienced. This was in line with the results of the NHS Friends and Family Test and other feedback received by the practice.
• Staff told us they were happy to work at the practice and felt supported by the management team. Staff told us they were encouraged to raise concerns and share their views.
• We saw evidence that complaints were handled effectively, trends were analysed and lessons learned and distributed amongst relevant staff.
• The practice is an accredited eastern region clinical research network practice and an accredited training practice. The practice GP had been nominated for a “trainer of the year” 2016 award by the local university and this was celebrated by the practice.

The areas where the provider should make improvements are:

• Ensure that all actions arising from infection control audits are completed and monitored.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

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