Dr GAM Burnett and Partners, also known as Sonning Common Health Centre, is located in purpose built premises in a semi-rural area. It provides primary medical services to just over 8500 registered patients. The practice dispenses prescriptions to approximately one third of its patients.
We visited the practice location at Sonning Common Health Centre, Wood Lane, Sonning Common, Reading, RG4 9SW.
We spoke with 11 patients and 14 staff during the inspection.This was the first inspection since registration.The announced inspection at Sonning Common Health Centre took place on 8 July 2014.
We found the provider was in breach of the regulation, Management of medicines.
The practice operated from premises that were clean and well maintained. Systems were in place to report and learn from incidents to improve patient safety. The policies and procedure used by the service for the management of medicines had been reviewed, but were not always followed. Prescription pads completed by hand were not stored securely which increased the risk of prescriptions being misappropriated. Repeat prescriptions were signed by a GP after collection by the patient. Assurances could not be provided that refrigerated and non-refrigerated medicines were stored within their recommended temperature ranges.
Staff told us if they suspected abuse in children or adults they would raise concerns with the GP. We found staff had received training in safeguarding children but not in safeguarding adults. Emergency procedures were in place to respond to medical emergencies.
Systems were in place to ensure evidence based practice including national and local guidelines were used and monitored through audits. The practice supported patients to adopt healthy lifestyles by facilitating exercise programmes such ‘Health Walks’, cycling club and a gardening project.
The practice nurses were developed in their roles. For example, the lead nurse for diabetes was an advanced nurse practitioner in diabetes education and provided support to patients with diabetes. All staff received regular appraisals.
The practice was caring and compassionate in its approach. We spoke with 11 patients. They were very positive about all aspects of the care they received. This was supported by the national GP survey results for this practice. We also observed staff were respectful in their interactions with patients in a way that preserved their dignity and confidentiality.
The practice understood the different needs of the population it served and had developed services to meet their needs. For example, late evening and fortnightly Saturday morning surgeries were offered. A complaints system was in place to investigate and take action where concerns were identified.
Staff described a supportive team environment to provide a patient centred service. Governance arrangements were in place that ensured patients needs were a priority. Staff told us they were comfortable to raise issues and concerns when they arose and were confident they would be dealt with constructively. However, a whistleblowing policy was not in place.
All the GPs mentioned the practice’s focus on education. All staff had been appraised in the last year. Staff said they had mandatory training updates. For example, in infection control, child safeguarding and basic life support. However, a robust system for recording and monitoring all staff training needs was not in place. The practice were aware of this but had not yet addressed this issue.
The practice considered the needs of older people in all aspects of the delivery of the service. The GPs involved patients and family in discussions before completion of the do not attempt cardiopulmonary resuscitation form. GPs and nurses were aware of what action to take if they judged a patient lacked the mental capacity to give their consent and they acted appropriately.
The practice supported patients with long term conditions to manage their health, care and treatment. The practice nurses were trained and experienced in providing diabetes and asthma care to ensure patients with these long term conditions were regularly reviewed and supported to manage their conditions.
Specific services for mothers, babies, children and young people included weekly antenatal clinics, baby immunisation clinics and baby development clinics. Family planning clinics were offered in the evening to improve access for young people.
The practice had introduced fortnightly Saturday morning surgeries and a weekly late evening surgery for routine appointments, to accommodate the needs of working age people.
The patient participation group was running a campaign to promote a local carers group which highlighted the support carers needed in relation to their own health and well-being.
The practice was working towards the joint Oxfordshire dementia plan to increase awareness and improve identification of patients at risk of dementia.