Cutlers Hill Surgery

Updated 10 February 2020

• The name of the registered provider is Cutlers Hill Surgery. The practice address is Bungay Road, Halesworth, Suffolk, IP19 8SG.
• There are approximately 10,500 patients registered at the practice living in the rural Suffolk town of Halesworth and the surrounding villages.
• The practice is registered to provide diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
• The practice has a General Medical Services (GMS) contract with the local Clinical Commissioning Group (CCG).
• The practice has two GP partners, (both male) who hold managerial and financial responsibility for the practice. There are regular GP locums at the practice, some of whom are female. The nursing team includes four nurse practitioners, four practice nurses, two healthcare assistants and one mental health worker. There are also two emergency care practitioners. There is a practice manager and assistant practice manager. There is an information technology manager and a reception office manager who leads a team of administration and reception staff, and a lead medical secretary, leads a team of three medical secretaries. A dispensary manager leads a team of dispensers.
• The practice provides a minor injury service for registered, non-registered patients and temporary residents.
• The practice was able to offer dispensing services, to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.
• District nurses and the community matron were based at the practice.
• The practice is a training practice for nursing students. The practice did not have any students based at the practice at the time of the inspection.
• The practice website is http://www.cutlershillsurgery.co.uk
• The practice is open between 8am to 7pm Monday to Friday. The practice opens one Saturday every two months from 8.30am to 11.30am. There is a rolling rota system in place to offer extended hours until 8pm one day a week and this day changes each week.
• When the practice is closed, IC24 provides the out of hours service; patients are asked to call the NHS 111 service to access this service, or to dial 999 in the event of a life-threatening emergency.
• The practice has a below average number of patients between the ages of 0-18, and an above average number of patients aged 65 and over, compared to the national average. Male and female life expectancy in this area is in line with the England average at 81 years for men and 84 years for women. Income deprivation affecting children is 15%, which is below the England average of 20% and above the CCG average of 23%. Income deprivation affecting older people is 11% which is in line with the England average of 20% and the CCG average of 18%.

Updated 10 February 2020

We undertook an inspection of this service on 27 January 2020 following our annual review of the information available to us. This inspection was to follow up on the breach of regulation identified at our previous inspection in February 2019 and we reviewed the safe key question only. Previous reports for this service can be found by following the links for Cutlers Hill Surgery at www.cqc.org.uk.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

We have rated this practice as good for providing safe services. The provider continues to be rated as good overall.

At this inspection we found that the provider was providing safe services because:

• We saw prescription pads were stored and logged in line with guidance. Access to prescription pads was limited to authorised staff only. The policy had been updated to reflect this.
• The dispensary had improved the monitoring and recording of the expiry dates of medicines. Standard operating procedures had been updated to reflect new processes.
• Staff discussed safety alerts at clinical meetings and circulated updates to all appropriate staff. We looked at four alerts and found one was in the process of being managed and three had been managed appropriately.

In addition, we found that:

• The practice had recently changed clinical systems and were in the process of sending further letters to patients with learning disabilities to invite them for a review. The provider had 47 patients on the register and had completed two reviews and two additional patients had been invited for a review but did not attend their appointment. We saw the practice were aware of this and had pre-booked two clinics to complete further reviews. The practice told us they were unlikely to complete all reviews by April 2020 but had a specially trained nurse to complete the reviews. The practice had reviewed their invite letters to ensure they were appropriate for patients with a learning disability and appointments were 90 minutes long. The health assessment completed was sufficiently detailed and we saw evidence that healthy eating advice was given to patients in an accessible format.
• Clinical updates, including patient safety alerts, were on the agenda for clinicians which were held every three months and were attended by nursing staff and the emergency care practitioners. These meeting minutes were held on the shared drive for staff to access.

The area where the practice should make improvements:

• Continue to improve the uptake of health checks for people with a learning disability.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BS BM BMedSci MRCGP
Chief Inspector of General Practice

Updated 12 March 2019

Updated 12 March 2019

Updated 12 March 2019

Updated 12 March 2019

Updated 12 March 2019

Updated 12 March 2019