1 November 2017
During a routine inspection
Letter from the Chief Inspector of General Practice
This practice is rated as good overall. (At the previous inspection undertaken in October 2014, the practice received a good overall rating, with an outstanding rating for providing responsive services)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
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 – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced comprehensive inspection at Darley Dale Medical Centre on 1 November 2017. 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 partners invested high levels of funding in their practice team to provide sufficient capacity, and ensure there was adequate and trained administrative support to relieve pressures on clinical time.
- There was strong clinical leadership and we saw how this impacted positively upon the quality of the service. For example, the GP prescribing lead had overseen cost effective prescribing, and lower rates of antimicrobial prescribing.
- The practice had a live strategy which focussed on the new challenges faced by general practice. This was supported by the appointment of a strategic business manager, and a new premises development to provide an environment to respond to local patients’ needs.
- We spoke with community based health, social and care home staff who overwhelmingly provided us with positive feedback about their interactions with the practice team, In particular, we observed that the relationship with social care was driving responsive and compassionate care for patients, including keeping those at risk from harm safe.
- The practice had received the Derbyshire Dignity Award in 2013 and continued to aspire to maintain this achievement. At the time of our inspection, the practice had submitted an application to the county council as part of the biennial renewal which focused on their work with local care homes.
- Results from the latest national GP patient survey showed that the practice had performed above local and national averages in the majority of the questions about patient experience. This was particularly evident in relation to GP access and comments regarding being cared for in a dignified and respectful manner.
- Patients who responded that they were satisfied with the practice’s opening hours was marginally below the local and national averages. The practice was proactively looking to address this via a collaborative approach with other practices to implement an 8am-8pm hub service locally.
- The practice encouraged and supported staff to report incidents and near misses. When incidents did happen, the practice learned from them and improved their processes. Positive events were also recorded in recognition that sharing best practice was an equally valid means of learning, and a way to celebrate success.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Care planning was embedded within the practice to reflect individual’s patients’ needs and their own wishes. We saw that 8% of patients had at least one care plan in place at the time of our inspection.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff training records were up to date, and regular appraisals encouraged development at all levels.
- The practice had an established quality improvement programme. This included involvement in research.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice