Winscombe Surgery Newapproachcomprehensive Report
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Winscombe Surgery Quality Report Winscombe Surgery Hillyfields Way Winscombe BS25 1AF Tel: 01934 842211/842911 Date of inspection visit: 22 November 2016 Website: www.winscombebanwellsurgery.nhs.uk Date of publication: 26/01/2017 This report describes our judgement of the quality of care at this service. It is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information given to us from the provider, patients, the public and other organisations. Ratings Overall rating for this service Good ––– Are services safe? Good ––– Are services effective? Good ––– Are services caring? Good ––– Are services responsive to people’s needs? Good ––– Are services well-led? Good ––– 1 Winscombe Surgery Quality Report 26/01/2017 Summary of findings Contents Summary of this inspection Page Overall summary 2 The five questions we ask and what we found 4 The six population groups and what we found 7 What people who use the service say 12 Detailed findings from this inspection Our inspection team 13 Background to Winscombe Surgery 13 Why we carried out this inspection 13 How we carried out this inspection 13 Detailed findings 16 Overall summary Letter from the Chief Inspector of General • Staff assessed patients’ needs and delivered care in Practice line with current evidence based guidance. Staff had We carried out an announced comprehensive inspection been trained to provide them with the skills, at Winscombe and Banwell Family Practice on 22 knowledge and experience to deliver effective care November 2016. The practice is registered as two and treatment. locations, Winscombe Surgery and Banwell Surgery; • Patients said they were treated with compassion, patients could book an appointment at either location. dignity and respect and they were involved in their All data relating to the performance of the practice has care and decisions about their treatment. been aggregated and relates to both locations. • Information about services and how to complain was available and easy to understand. Improvements were Overall the practice is rated as good. made to the quality of care as a result of complaints Our key findings across all the areas we inspected were as and concerns. follows: • Patients said they found it easy to make an appointment with a named GP and urgent • Staff understood and fulfilled their responsibilities to appointments were available the same day. The raise concerns and report incidents and near misses. practice had reviewed their clinical team to improve All opportunities for learning from internal and accessibility to a clinician. All clinical members of the external incidents were maximised. There was an team carried out some of the home visits and open and transparent approach to safety and an undertook patient medication reviews. Feedback from effective system in place for reporting and recording the patient participation group (PPG) members was significant events. positive and they told us on the day of the inspection • Risks to patients were assessed and well managed. that there was continuity of care and they were able to get appointments when they needed them. • The practice worked closely with other organisations and with the local community in planning how 2 Winscombe Surgery Quality Report 26/01/2017 Summary of findings services were provided to ensure that they meet There was a clear leadership structure and staff felt patients’ needs. For example, they provided a weekly supported by management. The practice proactively onsite clinic at an assisted living site and also arranged sought feedback from staff and patients, which it acted for a weekly community minibus service from there to on. the practice so patients could access other practice • The provider was aware of and complied with the based services. requirements of the duty of candour. • The practice had good facilities and was well equipped The areas where the provider should make improvement to treat patients and meet their needs. are: • The practice used innovative and proactive methods to improve patient outcomes, working with other local • Ensure that regular fire safety drills are undertaken providers to share best practice. For example, they and involve all staff. were involved in several pilot schemes to improve • The provider should ensure the electrical installation patient access to services such as the onsite mental safety check is kept up to date. health specialist nurse. • The practice had strong and visible clinical and Professor Steve Field (CBE FRCP FFPH FRCGP) managerial leadership and governance arrangements. Chief Inspector of General Practice 3 Winscombe Surgery Quality Report 26/01/2017 Summary of findings The five questions we ask and what we found We always ask the following five questions of services. Are services safe? Good ––– The practice is rated as good for providing safe services. • There was an effective system in place for reporting and recording significant events. • The practice used every opportunity to learn from internal and external incidents, to support improvement. Learning was based on a thorough analysis and investigation. Lessons were shared to make sure action was taken to improve safety in the practice. • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again. • Risk management was comprehensive, well embedded and recognised as the responsibility of all staff. However, we found that fire drills were not up to date and that the premises electrical installation safety was out of date. • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse. Are services effective? Good ––– The practice is rated as good for providing effective services. • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average. • Staff assessed needs and delivered care in line with current evidence based guidance. • Clinical audits demonstrated quality improvement. • Staff had the skills, knowledge and experience to deliver effective care and treatment. • There was evidence of appraisals and personal development plans for all staff. • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs. The practice used innovative and proactive methods to improve patient outcomes and working with other local providers to share best practice. • End of life care was delivered in a person centred and coordinated way. 4 Winscombe Surgery Quality Report 26/01/2017 Summary of findings Are services caring? Good ––– The practice is rated as good for providing caring services. • Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. We found many positive examples to demonstrate how patient’s choices and preferences were valued and acted on. • We observed a strong patient-centred culture with clinicians who demonstrated ownership of their patients and their treatment. • Data from the national GP patient survey (July 2016) showed patients rated the practice higher than others for several aspects of care. • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. • Information for patients about the services available was easy to understand and accessible. Are services responsive to people’s needs? Good ––– The practice is rated as good for providing responsive services. • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and North Somerset Clinical Commissioning Group to secure improvements to services where these were identified. The practice was a member of the One Care Consortium (an integrated approach to the delivery of primary care across GP practices in Bristol, North Somerset and South Gloucestershire) and was actively involved in the pilots for evening and weekend access to routine GP and nurse appointments; the provision of a practice-based specialist mental health nurse to see patients with low mood, anxiety and depression as an expansion of the clinical workforce. • The practice had good facilities and was well equipped to treat patients and meet their needs. • The practice took account of the needs and preferences of patients with life-limiting progressive conditions, including patients with a condition other than cancer and patients living with dementia. We found many positive examples to demonstrate how patient’s choices and preferences were valued and acted on. • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders. 5 Winscombe Surgery Quality Report 26/01/2017 Summary of findings • There are innovative approaches to providing integrated patient-centred care. • Patients can access appointments and services in a way and at a time that suits them. Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. Are services well-led? Good ––– The practice is rated as good for being well-led. • The practice had a clear vision and strategy to deliver high quality care and promote good