We carried out an announced comprehensive inspection at The Osmaston Surgery on 12 February 2016. The overall rating for the practice was good with requires improvement for providing effective services. A breach of legal requirement was found and requirement notice in relation to safe care and treatment issued. The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for The Osmaston Surgery on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 24 May 2018 to confirm that the practice met the legal requirement in relation to the breach in regulation that we identified in our previous inspection on 12 February 2016.

Our key findings are as follows:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice identified learning from them. However, not all staff were fully engaged in process of learning from significant event and complaint reviews as they didn’t attend the meetings.
• The practice worked closely with other health and social care professionals involved in patient’s care. Regular meetings with the community health and social teams and palliative care teams were held to discuss the care of patients who were frail / vulnerable or who were receiving end of life care. The practice met regularly with the health visitor and midwife leads to discuss children at risk.
• The practice had carried out clinical audits to review the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines. The audits seen demonstrated quality improvements.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had reviewed the results of the national GP survey published in July 2017 and developed an action plan to improve results.
• The practice provided a range of appointments, including ‘drop in’ clinics every day. Patients told us they could usually get an appointment when they needed one.

There were areas of practice where the provider should make improvements..

The provider should:

• Update the safeguarding policies to include information about modern slavery and the contact details for
• Demonstrate the competence of staff employed in advanced roles by audit of their clinical decision making.
• Promote staff engagement in the sharing of learning from significant event and complaint reviews.
• Document the risk assessments for
• Carry out a risk assessment to assess whether they needed to keep medicine to treat croup in children in stock
• Share the practice vision with the staff team.
• Fully utilise all opportunities for learning and improving performance.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Osmaston Surgery on 12 February 2016. Overall the practice is rated as good.

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

• The appointment system was flexible and ensured that patients who requested to be seen on the same day were.

• The practice had good facilities including disabled access. Patients who could not manage the stairs were seen on the ground floor.

• Information about services and how to complain was available, however, not in a format that could be understood by all patients. The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG).

• The practice used interpreting services enabling patients whose first language was not English to access the services available. However, access to written information in other languages was not readily available.

• The practice proactively managed care plans for some vulnerable patients and had effective management strategies for patients at the end of their life.

• There were systems in place to reduce risks to patient safety for example, infection control procedures.

• Staff identified a clear leadership structure, good team work, and felt supported by the management.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. There was a training programme however; training in the Mental Capacity Act 2005 had not been provided. Senior staff provided assurance of their competencies in mental capacity assessment through case examples.

• The practice performance in relation to the management of patients with long term conditions, learning disabilities, and people experiencing mental health was mixed and exception reporting in these areas was high. The practice staff were unable to inform us what they would do to try and reduce this.

The areas where the provider must make improvement are:

• Take proactive steps to ensure patients receive safe care and treatment by reviewing exception reporting to mitigate the risks to ensure their health and wellbeing.

• Ensure patients with learning disabilities receive an annual health review with care plans written.

• Improve the identification of and support to carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice