Box Surgery Also known as Dr Gruffydd-Jones & Partners

We carried out an announced comprehensive inspection of Box Surgery in January 2019 and rated the provider as requires improvement for providing safe and well led services, and good for providing effective, caring and responsive services. On 26 November 2019 we carried out a comprehensive inspection to follow up on breaches of regulations found during the inspection carried out in January 2019.

We based our judgement of the quality of care at this service 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 overall and good for all population groups.

On the inspection we found:

• Processes to keep patients safe had been improved and embedded. These included, recruitment, infection prevention control processes and appropriate risk assessments were in place.
• Patients received effective care that was in line with national guidance and outcomes were in line with other similar services.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• Feedback from patients about the service delivered by the practice was positive.
• Leadership within the practice had been strengthened. Improved governance processes were in place to support the delivery of high-quality care.

Whilst we found no breaches of regulations, the provider should:

• Continue to improve the uptake of cervical cancer screening.
• Take action, to ensure infection prevention control processes are fully embedded across both sites.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Box Surgery on 10 January 2019 as part of our inspection programme. At the previous inspection on 22/06/2016 the practice was rated as good)

We have rated this practice as Requires Improvement overall and good for all population groups.

We based our judgement of the quality of care at this service 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.

The key questions are rated as:

• Are services safe? – Requires Impprovement
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Box Surgery on 10 January 2019 as part of our inspection programme.

We rated the safe, effective and well-led domains as requires improvement because:

• There was limited evidence the practice assessed, managed and where appropriate, mitigated risks to patients and staff. For example, there was no evidence the practice had considered any risks that might be inherent with their premises.
• There was no evidence that the risks which had been identified, had been shared with the partners or that appropriate action had been taken.
• There was no evidence the practice had carried out an audit of their infection prevention and control measures since October 2014.
• Shingles vaccines had been given by staff of the practice without patient specific directives being in place.
• The practice had no adequate system or process for ensuring that actions required were monitored or completed in a timely way. There was no evidence that actions which had been agreed were monitored by the partners.

At this inspection we also found:

• In the past 12 months there had been a change in the leadership in the practice which was part of a long-term succession plan.
• In October 2018 the practice suffered a severe flood which tested their resilience and emergency plan. The subsequent renovations had been completed shortly before our inspection.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Feedback from patients indicated a high level of satisfaction. For example, 100% of patients who responded in the most recent national GP survey said they had confidence and trust in the last healthcare professional they saw or spoke.
• 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.

The areas where the provider must make improvements are:

• The provider must ensure care and treatment is provided in a safe way to patients
• The provider must ensure they have systems or processes established and operated effectively to ensure compliance with their policies and procedures and any regulations which apply.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice