Letter from the Chief Inspector of General Practice

This practice is rated as good overall. (Previous inspection May 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Stubbington Medical Practice on 8 January 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.

• Care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• The practice understood the needs of its population and tailored services in response to those needs. For example extended opening hours, online services such as repeat prescription requests, advanced booking of appointments, advice services for common ailments. Weekly prescriptions were used for patients who were at risk of over-using medicines. A dedicated member of the prescription team worked with care homes and the clinical commissioning group pharmacist to monitor and reduce polypharmacy, prevent errors and improve efficiency.

• Annual reviews were offered for patients who had a learning disability. A GP acted as a link person for patients with learning disabilities who were living in care homes and would offer home visits if needed.

• Innovation and improvement was a priority among staff and leaders:

• For example the practice had introduced home visits by one of the practice nurses in March 2015 at the time of this inspection this was on two days a week. Additionally the practice had introduced Friday visits to care homes to proactively review patients to avoid unnecessary hospital admissions over the weekends.

The areas where the provider should make improvements are:

• Continue with the review of training records to demonstrate what training staff have received.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Stubbington Medical Practice on 10 May 2016. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• Team away days took place regularly and all staff had a forum to raise issues outside of the formal GP clinical meetings.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review the identification of carers and implement a support mechanism for this patient group.

• Review the practice method of ensuring that people with mental health problems receive the appropriate health checks. Ensure the exception rate in this area of clinical targets accurately reflects care given.
• Review patient survey feedback, with the aim of improving patient awareness and understanding of opening times and access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with six people who used the service, this included two active members of the Patient Participation Group (PPG), and with clinical and non-clinical staff.

People we spoke with were positive about the service they received. People told us they didn’t have any problems getting an appointment. People told us that the staff were caring, respectful and polite. One person told us, “I would give them 10 out of 10”. People said that during consultations the doctors explained issues and answered questions in a way they could understand. One person told us, “I am always given the options so I can make my own decision”.

People received care that ensured their safety and welfare. People were assessed and care was provided to meet their individual needs. Diagnostic tests were carried out if necessary and appropriately followed up.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and respond appropriately.

The practice ensured people were protected by carrying out appropriate checks on staff.

The practice monitored the quality of the service by audits and seeking the views of the patients by surveys and engagement in the Patient Participation Group (PPG).