We carried out a review of the data available to us about Barnfield Hill Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Barnfield Hill Surgery, you can give feedback on this service.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
This practice is rated as Good overall. (The previous inspection of Barnfield Hill Surgery took place in October 2014. At the October 2014 inspection the practice was rated as Good.
At this inspection we have rated the practice as Good overall and requires improvement in the well led domain.
At this inspection in November 2017 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? - Requires Improvement
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 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 Barnfield Hill Surgery on Friday 17 November 2017. We carried out this comprehensive inspection 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 is 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 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. It ensured that care and treatment was delivered according to evidence- based guidelines.
Staff involved and treated patients with compassion, kindness, dignity and respect.
Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
The areas where the provider must make improvements as they are in breach of regulations are:
Ensure effective systems and processes are established to ensure good governance in accordance with the fundamental standards of care, particularly in regard of; record keeping and staff development.
The areas where the provider should make improvements are:
Review the method of obtaining consent for invasive procedures ensuring it is performed in line with legislation and guidance.
Review systems to identify carers to ensure they are receiving the support they require.
Review systems to ensure all staff are aware of the ‘red flag’ symptoms and actions to take when sepsis is suspected to promote patient safety.
Review training schedules to ensure staff receive sufficient time to undertake mandatory training and information on the Mental Capacity Act.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
Barnfield Hill Surgery was inspected on Wednesday 1 October 2014. This was a comprehensive inspection.
Barnfield Hill provides primary medical services to people living in the city of Exeter, Devon and the surrounding areas. The practice provides services to a diverse population and is situated in a city centre location.
At the time of our inspection there were approximately 7,300 patients registered at the service with a team of six GP partners. GP partners held managerial and financial responsibility for running the business. In addition there was an additional salaried GP, three registered nurses, a phlebotomist, a practice manager, and additional administrative and reception staff.
Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.
Our key findings were as follows:
We rated this practice as good. Patients reported having good access to appointments at the practice and liked having a named GP which improved their continuity of care. The practice was clean, well-organised, had good facilities and was well equipped to treat patients. There were effective infection control procedures in place.
The practice valued feedback from patients and acted upon this. Feedback from patients about their care and treatment was consistently positive. We observed a patient centred culture. Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Views of external stakeholders were very positive and were aligned with our findings.
The practice was well-led and had a clear leadership structure in place whilst retaining a sense of mutual respect and team work. There were systems in place to monitor and improve quality and identify risk and systems to manage emergencies.
Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessment of a patient’s mental capacity to make an informed decision about their care and treatment, and the promotion of good health.
Suitable staff recruitment, pre-employment checks, induction and appraisal processes were in place and had been carried out. Staff had received training appropriate to their roles and further training needs had been identified and planned.
Information received about the practice prior to and during the inspection demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area.
Patients told us they felt safe in the hands of the staff and felt confident in clinical decisions made. There were effective safeguarding procedures in place.
Significant events, complaints and incidents were investigated and discussed. Learning from these events was communicated and acted upon, although the written evidence for this process did not always consistently show what learning and actions had taken place following such investigations.
There were also areas of practice where the provider needed to make improvements.
The provider should:
Improve record keeping from accidents, significant events and complaints to show learning and actions taken.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
Staff were clear about what action they would take if they saw or suspected any abuse. Staff had completed some training in relation to this. Policies and procedures were in place to guide staff practice on their computer system and would be made more visible on the notice board for staff following our visit.
We talked with patients about their confidence in the staff. People told us that the surgery and staff were 'lovely', one patient adding that 'It doesn't feel clinical but friendly ' it is like walking into someone's own home.'
There were appropriate arrangements in place to ensure staff kept their knowledge and skills up to date. All staff spoke about how they enjoyed working at the surgery and the "good team work" and about working in a "supportive environment."
The surgery was organised and well managed. There were effective systems in place to regularly monitor the quality of the service provided and patients felt able to give feedback about the service they received knowing that they would be listened to.