This practice is rated as good overall (outstanding in the responsive domain). (The previous inspection was in July 2015 where we rated the practice as good overall and outstanding in caring)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

We carried out an announced comprehensive at Whipton Surgery on Monday 21 May 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.
• Medicines were managed well at the practice and prescribing rates and patterns were kept under review to ensure safety.
• 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 gave detailed positive feedback about the care and treatment they received. Results from the July 2017 national GP patient survey, friends and family test results, CQC comment cards and independent survey results were all positive. Of the 60 CQC comment cards we received and interviews with six patients, all were positive about the staff group, access, care and treatment received. There were no negative comments received.
• 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 practice continued to be a popular teaching and training practice, with all four partners registered as trainers.
• Staff said the practice was a good place to work and added that the leadership team were supportive and encouraged career development and learning to help improve patient safety.
• There was evidence of systems and processes for learning, continuous improvement and innovation. The practice had taken part in local pilots and research.
• Networking continued to be a priority of leaders and staff to deliver safe, effective, caring and well led service. For example, the practice manager was the LMC (Local medical council) pastoral support officer and director of finance for the Exeter Primary care federation.

We saw an area of outstanding practice:

The practice nurse provided a complex wound dressing service and the clinical team had introduced a domiciliary visiting nursing service for patients whose needs did not meet the threshold of the community nursing teams. 82 home visits from the practice nurse in seven months had been completed to offer additional services including ECG (Heart tracing), nebuliser treatment, urgent blood tests and long term condition monitoring. The nurse had been runner up in the local 2018 Practice nurse of the year award for this service.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice