Little Bushey Surgery

We carried out an announced comprehensive inspection at Little Bushey Surgery on 13 November 2019 as part of our inspection programme.

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.

We rated the practice as requires improvement for providing safe services because:

• The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation were not always comprehensive.
• Although not part of the requirement notice due to the practice’s immediate actions, there were some concerns that contributed to the requires improvement rating for the safe key question. They included those relating to: staff vaccinations, carpet flooring risk assessment, the security of prescription stationery, a protocol for the healthcare assistant, and the practice’s emergency medicines supply.

Please see the final section of this report for specific details of our concerns.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

• Patients received effective care and treatment that met their needs. The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Staff involved patients in their care and treatment decisions and treated them with kindness, dignity and respect.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high quality, person-centred care and an inclusive, supportive environment for staff. There was a focus on continuous learning and improvement at all levels of the practice. Where we identified any concerns during our inspection, the practice took immediate action to respond or plans of action were in place to ensure any issues were resolved.

The area where the provider must make improvements is:

• Ensure care and treatment is provided in a safe way to patients.

Please see the final section of this report for specific details of the action we require the provider to take.

The areas where the provider should make improvements are:

• Continue to strengthen policies, systems and processes for the appropriate and safe use of medicines. Especially those in relation to the prescribing of Hypnotics medicines, emergency medicines provision, Patient Specific Directions (PSDs) protocols and monitoring the use of blank prescription stationery.
• Continue to strengthen policies, systems and processes in relation to staff vaccinations, and encouraging women to attend for their cervical screening and patients to engage in national cancer screening programmes.
• Continue to take steps so that existing infection prevention and control, and health and safety risk assessment processes are strengthened.
• Take steps to improve access to the practice. This includes improving levels of patient satisfaction in relation to the National GP Patient Survey results and access to the practice for patients with a disability or mobility issues.
• Continue to identify and support carers in the practice population.

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