26 October 2015
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Meadows Medical Practice on 26 October 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
- The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
- The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
- The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
- The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
- The practice’s rural community dispensary and practice also provided the addition of a pharmacy in response to meeting the needs of their local community.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
- Patients said they found it easy to make an appointment with a named GP and that there was excellent continuity of care, with urgent appointments available the same day, as well as a walk in and wait service each morning.
We saw several areas of outstanding practice including:
- The practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the GP out-of-hours service and very positive patient survey results.
- The practice had systems in place that reflected best practice in end of life care and demonstrated an ethos of caring and striving to achieve a dignified death for patients. This was actively supported by practice staff and local community initiatives.
- The practice was presented with significant challenges in time management, patient transport services and responded effectively to support their patients. Mobile telephone and email signals were not always reliable in the remote rural locations the practice covered, which was an area of approximately 200 square miles. The practice staff supported patients by enabling continuity of care with little or no changes in staff for several years, local knowledge and staff awareness of their local community.
However there were areas of practice where the provider should make improvements:
- There should be a formalised assessment of risk in place where non-clinical staff that were trained to carry out chaperone duties had no criminal record checks through the Disclosure and Barring Service (DBS) in place.
- Consider making a hearing loop available for patients and an emergency call bell system for the patient toilet facility.
- Consider automated doors for patients with physical disability.
- Document the practice whistleblower policy and make this accessible to all staff.
- Consider documenting the practice business plan and strategy.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice