22 February 2018
During a routine inspection
We carried out an announced comprehensive inspection at Clifton House and Nook Group Practice on 6 June 2017. The overall rating for the practice was Inadequate and it was placed into Special Measures. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for Clifton House and Nook Group Practice on our website at www.cqc.org.uk.
This inspection was an announced comprehensive inspection carried out on 22 February 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 6 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
The practice is now rated as Good overall, with the key question of are services effective rated as Requires Improvement.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Requires Improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
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 recently retired and students) – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
Our key findings at this inspection were:
- The practice had taken action to remedy the breaches in regulation identified at the previous inspection.
- The practice now 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. When things went wrong, reviews and investigations were thorough and lessons learned were communicated throughout the practice to support improvement.
- The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines. We saw that the system for sharing drug safety alerts across the practice was sufficiently monitored.
- We saw that staff treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and told us that they were able to access care when they needed it.
- There was now a focus on continuous learning and improvement at all levels of the organisation.
- The patients and staff benefitted from access to the protocol, ‘death of patient’. This ensured that all aspects of death and bereavement were dealt with appropriately, in a timely and sensitive manner. This also helped the GPs to facilitate early burial for religious reasons.
The areas where the provider should make improvements are:
- Continue to improve performance as measured by the Quality and Outcomes Framework (QOF) in order to improve the care and treatment received by their patient population.
I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service. These improvements now need to be sustained, moving forwards.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice