This practice is rated as Outstanding overall.
(Previous inspection January 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Outstanding
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Outstanding
Families, children and young people – Good
Working age people (including those retired and students – Good
People whose circumstances may make them vulnerable – Outstanding
People experiencing poor mental health (including people living with dementia) - Good
We carried out an announced comprehensive inspection at The Scott Practice on 21 March 2018 as part of our inspection programme.
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. Care and treatment was always delivered according to evidence- based guidelines.
- Those whose circumstances made them vulnerable, frail older people and those with multiple long term conditions were well supported by the practice who employed a pro-active care team.
- Staff involved and treated patients with compassion, kindness, dignity and respect.The practice was above average for its satisfaction scores on consultations with GPs and nurses.
- Recent improvements had been made to the telephone system and patients found it easy to use the appointment system and reported that they were able to access care when they needed it.
- There was innovation and service development and improvement was a priority among staff and leaders.
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At the core of the practices ethos, was learning and development across all staff groups.
We saw areas of outstanding practice:
- The practice used innovative and proactive methods to improve patient outcomes and worked with other local providers to share best practice. In October 2016 the practice linked with six neighbouring practices to hold quarterly meetings with the wider multidisciplinary team which included a respiratory nurse, community geriatrician, a representative from the local social prescribing initiative, palliative care nurses, district nurses, heart failure nurse, social services and the falls team. This provided the opportunity to review those patients considered most at risk and a forum for sharing best practice and learning through review of case studies.
- The practice ensured that patients with complex needs, including those with life-limiting progressive conditions, were supported to receive coordinated care in innovative and efficient ways.The practice employed a care co-ordinator nurse to review and implement care plans for those patients whose circumstances may make them vulnerable. Initially, patients were assessed using a risk stratification tool which included review of patients living with dementia, learning difficulties, frailty, at risk of hospital admission, housebound, residing in care home or those with multiple long term conditions. The care co-ordinator had identified 255 patients at risk and 89% of these patients had agreed care plans in place.
- There was compassionate, inclusive and effective leadership at all levels. All leaders demonstrated high levels of experience, capacity and capability needed to deliver excellent and sustainable care.
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There was a demonstrated commitment to best practice performance and risk management systems and processes. The practice reviewed how they functioned to
ensure that staff at all levels have the skills and knowledge to use those systems and processes effectively. Problems were identified and addressed quickly and openly.
The areas where the provider
should
make improvements are:
- Review monthly checks of emergency medicines and consider completing a risk assessment in the absence of keeping a stock of Atropine, a medicine to treat slow heart beat.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice