Cornford House Surgery - Care Quality Commission

Background to this inspection

Updated 4 October 2017

Cornford House Surgery is situated in Cambridge, Cambridgeshire. The practice provides services for approximately 11,300 patients. It holds a General Medical Services contract with the local Clinical Commissioning Group (CCG). There is a branch site in the nearby village of Fulbourn which we did not visit as part of this inspection.

The practice has two male and four female GP partners and one male and two female salaried GPs. The team also includes four practice nurses, two health care assistants and one phlebotomist. They also employ a practice manager, 16 reception and administrative staff and two secretaries. The practice is a teaching and training practice and had one registrar at the time of the inspection.

The practice is open between 8.15am and 6pm Monday to Friday. Appointments can be booked up to six weeks in advance with GPs and nurses. Urgent appointments are available for people that need them, as well as telephone appointments. Online appointments are available to book up to one month in advance. During out-of-hours GP services are provided by Herts Urgent Care via the 111 service.

We reviewed the most recent data available to us from Public Health England which shows that the practice has a lower than average practice population aged between 10-24 and a higher than average practice population between 35-44 and over 85 compared with the national England average. The deprivation score is significantly lower than the average across England.

Income deprivation affecting children is 9%, which is lower than the CCG average of 16% and the national average of 20%. Income deprivation affecting older people is 13%, which is equal to the CCG average of 13% and lower than the national average of 16%. Life expectancy for patients at the practice is 81 years for males and 84 years for females; this is higher than the CCG and England expectancy which is 79 years and 83 years respectively.

Overall inspection

Good

Updated 4 October 2017

Letter from the Chief Inspector of General Practice

This inspection was an announced focused inspection carried out on 7 September 2017 to confirm that the practice had carried out improvements that we identified in our previous inspection on 11 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is still rated as good, and requires improvement for the safe domain. Our key findings were as follows:

The systems and processes to systematically record safety alerts had been improved and showed the alerts had been recorded, actions had been taken, and learning shared. This had improved the oversight of safety.
Annual infection prevention and control audits had been undertaken. However, we found out of date items in a clinical room and there was no system in place to check expiry dates of equipment.
We reviewed four personnel files and found appropriate recruitment checks had been undertaken prior to employment.
We found that there was a system to code patient records on the clinical system for children who did not attend a hospital appointment.
We reviewed three policies and found them to be up-to-date and reflective of current practice.
We reviewed the system for staff appraisals and found there was a comprehensive log to track when appraisals were due. We checked five staff appraisals and found these had all been completed in the last year.
The practice had improved the support offered to carers. There were leaflets in the waiting room which signposted carers to support groups and the practice had developed a ‘carer’s prescription’. This ensured that if a carer became unwell, the practice had systems in place to support both the carer and the person being cared for. The practice had identified 54 patients as carers (0.5% of the practice list).
The practice had recognised that results from the GP patient survey, published in July 2017, were in line with or below local and national averages for access. The practice had previously been using locum GPs but had employed two new partners in June 2017 to improve continuity of care. The practice had also employed a minor illness nurse. Other details of the action plan to improve patient satisfaction were; employing an emergency care practitioner, employing a pharmacist and changing the phone lines to a queue based system. They planned to complete a patient survey to assess whether their action plan was effective. The practice planned to complete these actions by the end of 2017. We spoke with nine patients on the day of inspection and eight of these were satisfied with access to the surgery. One reported difficulty accessing the same GP for continuity.

The areas where the provider should make improvements:

Continue to proactively identify and offer support to carers.
Continue to assess the impact of improvements made relating to patient’s access to services.
Implement a system to monitor expiry dates of equipment in clinical rooms.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice