Spinney Surgery Also known as The Spinney Partnership

This practice is rated as Requires Improvement overall. At the previous inspection in December 2015 the practice was rated as Good overall.

We carried out an announced focused inspection at Spinney Surgery on 21 August 2019. We decided to undertake this inspection following our annual review of the information available to us.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services well-led? – Requires Improvement

Caring and Responsive were not reviewed because patient feedback and monitoring indicated no change since the last inspection. The rating from the last inspection has been carried forward.

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.
• Information from the provider, patients, the public and other organisations.

At this inspection, the practice was rated as requires improvement for providing safe services because:

• We found the practice’s system for managing patient and drug safety alerts was not fully effective. The practice had implemented a new system from July 2019, but had not considered alerts received prior to this date.
• The practice’s system of recruitment checks was ineffective. We reviewed four staff personnel files and found a number of omissions including; Disclosure and barring service (DBS) checks, references, vaccination status and clinical registration checks.
• We found the practice did not have oversight of the progress of actions arising from a fire risk assessment.
• The process for sharing learning from significant events was not clear and staff were not always clear on learning which had been distributed.

At this inspection, the practice was rated as requires improvement for providing effective services because:

• We found the practice’s recall system was not effective. We identified three patients diagnosed with a mental health condition who had not received a review of their condition despite attending the practice multiple times for other issues.
• The practice’s exception reporting rate was higher than the CCG and England averages for long-term conditions and one mental health indicator. We reviewed submitted but unverified 2018/2019 data and found this high exception reporting rate had continued and increased.
• The practice did not have a program of quality improvement in place.
• The practice’s uptake of 40-74 and learning disability health checks was low.

At this inspection, the practice was rated as requires improvement for providing well-led services because:

• The practice could not evidence that risks, issues and performance were managed to ensure that services were safe or that the quality of those services was effectively managed.

However, we also found that:

• Members of staff we spoke with had a clear knowledge of safeguarding processes at the practice.
• Arrangements for dispensing medicines at the practice kept patients safe.
• The practice employed a number of clinical staff including an advanced nurse practitioner and an emergency care practitioner.
• The practice’s uptake of childhood immunisations was above the 90% World Health Organisation target rate.
• Staff told us morale was high and they felt well supported by the practice management team.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review and improve the prescription rate of co-amoxiclav, cephalosporins and quinolones.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care