Letter from the Chief Inspector of General Practice

At our previous comprehensive inspection at Woodlands Surgery in Banbury, Oxfordshire on 16 November 2016 we found a breach of regulation relating to the provision of effective services. The overall rating for the practice was good. Specifically, the practice was rated requires improvement for the provision of effective services and good for the provision of safe, caring, responsive and well-led services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Woodlands Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 27 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We found the practice had made improvements since our last inspection. Using information provided by the practice we found the practice was now meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

Our key findings were as follows:

• Understanding of the Mental Capacity Act 2005 had been addressed. All staff had undertaken training and had then been assessed by the trainer at a future session to evidence understanding.
• All staff had an appraisal within the last 12 months to ensure learning needs were identified.
• The practice had implemented systems to improve the uptake of learning disability health checks. This included more patient engagement and contacting patients to encourage uptake.
• The practice had implemented systems to improve the uptake of bowel and breast screening.
• Patient satisfaction has increased regarding GPs treating patients with care and concern. Satisfaction had increased by 7%, from 74% to 81%, over the last 12 months.

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 Woodlands Surgery on 16 November 2016. Overall the practice is rated as good.

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

• 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.
• All staff had received safeguarding relevant to their role.
• Data showed patient outcomes were similar to average for the locality. However, exception reporting was high in the quality outcomes framework (QOF) data from 2015/2016. Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects.
• 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.
• The practice used innovative and proactive methods to improve patient outcomes. For example, identifying and using social prescribing services to support patients to live healthier lives.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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 a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Ensure appropriate training is provided to all staff to improve awareness of the Mental Capacity Act 2005 and how it relates to their practice.
• Ensure all staff are given a regular appraisal to identify learning needs.

The areas where the provider should make improvement are:

• Ensure alternative ways of encouraging all patients with a learning disability to access health checks to improve health outcomes are explored.
• Ensure patient outcomes are continually reviewed to ensure that patients receive appropriate care and treatment. This would include a review of the system in place to promote the benefits of breast and bowel screening in order to increase patient uptake.
• Continue to review patient’s feedback and address concerns regarding seeing a GP of choice, waiting times and treating patients with care and concern during consultations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice