This practice is rated as Good overall.
We carried out an announced comprehensive inspection at Thorns Road Surgery on 18 June 2018. The overall rating for the practice was good. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
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.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence- based guidelines.
- Clinicians had access to appropriate information to deliver safe care and treatment.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported they could access care when they needed it. Patient feedback on the care and treatment delivered by all staff was positive.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
- Complete a physical and mental health assessment for all staff employed to ensure suitability to carry out their role.
- Carry out an assessment of the hard-wired electrical circuit within the building.
- Further improve the reporting of significant events.
- Review the system for managing safety alerts.
- Explore ways in which to increase the uptake for cervical cancer screening.
- Consider the implementation of a structured approach to quality improvement including a review of complaints to capture themes and trend from verbal complaints.
- Consider the introduction of a written business plan to support the strategic aims for the practice.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice