• Doctor
  • GP practice

Archived: The Meadows Surgery

Overall: Good read more about inspection ratings

Canal Way, Ilminster, Somerset, TA19 9FE (01460) 52284

Provided and run by:
Dr Antony David Leigh Austin

Important: The provider of this service changed. See new profile

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Background to this inspection

Updated 7 December 2017

The Meadows Surgery was registered as a partnership until the retirement of one of the two partners in June 2016. Dr Austin then registered as an individual provider and continued to operate the practice. The practice serves 3,500 patients and is located in the small town of Ilminster in a rural part of Somerset, some 12 miles south east of Taunton. The modern, purpose built premises are shared with another practice; and offers dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy. There is ample parking on site and the regulated activities are carried out at:

The Meadows Surgery

Canal Way

Ilminster

Somerset

TA19 9FE

The patient age distribution is similar to national and Somerset Clinical Commissioning Group (CCG) averages. There are slightly fewer patients aged 5 to 39 than the national average; and slightly more male patients aged 55 to 84 years than the national average. The practiced has 55% (2015/16 data) of patients with a long standing health condition, which is similar to the Clinical Commissioning Group (CCG) average of 56% and national average of 53%.

Other Population Demographics:

The percentage of patients in paid work or full time education:

60% (slightly lower than the national average of 63%)

The area is in the fourth less deprived decile in the national index of deprivation.

Index of Multiple Deprivation 2015 (IMD):

16 (lower than the national average of 22)

Income Deprivation Affecting Children (IDACI):

14% (lower than the national average of 20%)

Income Deprivation Affecting Older People (IDAOPI):

12% (lower than the national average 16%)

Average male and female life expectancy for the area is 82 and 86 years respectively, which are both three years more than the national average.

The practice has one GP who is the Individual Provider, supported one salaried GP; who together are equivalent to 1.3 whole time employees. One is male and one is female. Between them they provide twelve sessions of GP appointments each week, plus extended hours one evening per week.

There are three practice nurses, whose working hours are equivalent to 1.8 whole time employees (WTE); including one non-medical prescriber who offers the equivalent of 0.6 WTE per week. A fourth practice nurse offers ad hoc locum support. Two health care assistants are employed by the practice with combined hours of 1.2 WTE; along with four staff employed as dispensers. The GPs, nursing team and dispensers are supported by seven management and administrative staff including a practice manager. The practice is also supported by an emergency care practitioner and a clinical pharmacist.

The practice is open from Monday to Friday each week between 8.30am and 6pm, with telephone access from 8am until 6.30pm. Appointments are available typically from 8.30am until 12.30pm and 3.50pm to 5.50pm. Extended hours appointments, known as ‘improved access’, are offered on Thursday evening from 6.30pm to 7pm with the practice nurse; and alternate Thursdays between 6.30pm and 8pm with a GP and HCA. The dispensary is open Monday to Friday 8.30am to 6pm, except for closure, along with the practice, every Wednesday from 1pm to 2pm for staff training.

The practice operates a mixed appointments system with some appointments available to pre-book and others available to book on the day. The practice offers online booking facilities for non-urgent appointments and an online repeat prescription service. Patients need to contact the practice first to arrange for access to these services.

The practice has a General Medical Services (GMS) contract to deliver health care services; the contract includes enhanced services such as childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for patients with dementia and minor surgery services. An influenza and pneumococcal immunisations enhanced service is also provided. These contracts act as the basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

When the practice is closed patients are directed to the NHS 111 service where patients can be referred to Vocare GP Out of Hours service if further clinical advice is required. This practice along with a number of practices in Somerset Clinical Commissioning Group (CCG) opted out of national

QOF arrangements from 2014/15 onwards, in order to participate in an alternative, locally developed quality scheme (Somerset Practices Quality Scheme – SPQS). This means that reporting on individual clinical indicators will appear lower than practices who have continued to deliver national QOF. This does not mean that there was any drop in the quality of clinical care, practices were continuing to provide care in accordance with NICE guidelines.

Overall inspection

Good

Updated 7 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Meadows Surgery on 23 May 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for The Meadows Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 November 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 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • There were effective arrangements in place to assess, monitor, manage and mitigate risks in respect of health and safety. These included systems for addressing Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts; and reviewing patients’ medicines.
  • Effective systems and processes were in place to ensure good governance in accordance with the fundamental standards of care. In particular, systems were in place to assess, monitor and improve the quality and safety of the service, including those for up to date record keeping, such as for staff training; and there was a rolling programme quality improvement, such as completed cycles of clinical audits.
  • Sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed to meet the fundamental standards of care and treatment. In particular, staff had received and had a record of appropriate training relevant to their role, including infection prevention and control and safeguarding adults and children. Effective arrangements were in place to assess the competency of dispensary staff.
  • A risk assessment had been completed regarding the location of the vaccine storage fridge to ensure appropriate infection prevention and control.
  • Effective arrangements were in place for the security of blank prescription stationery when clinical rooms were not in use.
  • Arrangements for communication and records had been improved to ensure learning from complaints and incidents was shared and all actions were completed.
  • Arrangements for management & leadership had been improved to ensure all staff have clarity of role, these were embedded in teams and adequate capacity and contingency arrangements for absence were in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Working age people (including those recently retired and students)

Good

Updated 7 December 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 23 May 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People experiencing poor mental health (including people with dementia)

Good

Updated 7 December 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 23 May 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People whose circumstances may make them vulnerable

Good

Updated 7 December 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 23 May 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.