Archived: Dr Sarah Bond and partners Also known as Kingsclere Medical Practice

Updated 2 June 2017

Dr Sarah Bond and partners (also known as Kingsclere Medical Practice) is located at North Street, Newbury, Hampshire, RG20 5QX.

The practice provides services under a NHS General Medical Services contract and is part of the NHS North Hampshire Clinical Commissioning Group (CCG). The practice has approximately 5500 registered patients. The practice population has a slightly higher than average elderly population (19% are aged over 65 compared to a CCG and national average of 17%). There is a lower than average age of under 18s registered at the practice of 19%, compared with the CCG and national average of 21%. The practice population is predominantly White British with only 2.5% of registered patients being an ethnicity other than White British.

The practice is a dispensing practice dispensing medicine to approximately 50% of its patients. The building is owned by NHS Property Services. The practice has two GP partners and two salaried GPs which is equivalent to just under 3.5 full time GPs. One of the GPs is male. The GPs are supported by two practice nurses (equivalent to just over 1.5 full time nurses) and two health care assistants as well as a phlebotomist. The clinical team are supported by a management team including secretarial, dispensing and administrative staff.

The practice reception and phone lines are open between 8.30am and 6.30pm Monday to Friday. The practice operates an emergency telephone answering service from 8am to 8.30am and 1pm to 2pm daily. Extended hours appointments are offered on a pre-bookable basis from 6.30pm to 8pm every Monday. Morning appointments with a GP are available between 9am and 1pm daily. Afternoon appointments with a GP are available from 3pm to 6pm daily (Monday evening appointments are available until 8pm).

Dr Sarah Bond and Partners have opted out of providing out-of-hours services to their own patients and patients are requested to contact the out of hours GP via the NHS 111 service. The practice offers online facilities for booking of appointments and for requesting prescriptions.

Updated 2 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sarah Bond and partners on 7 June 2016. The overall rating for the practice was good, with the safe domain rated as requires improvement. The full comprehensive report on the 7 June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Sarah Bond and partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 25 April 2017 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 7 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection in April 2017 the practice is now rated as good overall and all domains are rated as good.

Areas which did not meet the regulations at the June 2016 inspection were:

• Vaccine fridge stock was not kept secure when treatment rooms were not in use.

• Prescription printer paper was stored in the printers in an unlocked room when unoccupied.

• Security of the controlled drugs cabinet was not maintained in that the keys were stored in an unlocked cabinet.

• Infection control procedures were not implemented in line with practice policy or as a result of recommendations from audits.

• Cleaning checks of treatment and consulting rooms were not recorded.

We made recommendations where the provider should make improvement on the following areas:

• Control and access to staff only areas.
• Arrangements for communicating with patients who are hard of hearing or who used hearing aids.
• Records of significant events to included actions resulting from clinical discussions.
• Coding all patients known to be vulnerable adults on the practices electronic records system and maintaining an up to date vulnerable adult risk register.
• Act on the results of the Legionella risk assessment.
• Reviewing arrangements for a Disclosure and Barring Service (DBS).

Key findings at the inspection on 25 April 2017:

• The vaccine fridge stock was kept secure when treatment rooms were not in use.

• Prescription printer paper was stored securely and removed from the printers when the rooms were unoccupied.

• Security of the controlled drugs cabinet was maintained and keys were stored in a locked cupboard.

• Infection control procedures were implemented in line with practice policy and as a result of recommendations from audits.

• Cleaning checks of treatment and consulting rooms were recorded.

We also noted that all recommendations where the provider should make improvements had been actioned:

• Access to staff only areas was restricted by the use of key pad locks.

• Staff had been trained on how to use the hearing loop and it was readily available.

• The processes for recording significant events had improved and now contained full details of actions resulting from clinical discussions.

• The practice maintained a register of vulnerable patients and ensured they were coded appropriately on their system. They had also reviewed their safeguarding adults policy to ensure it contained up to date and relevant information.

• An action plan had been implemented and carried out in line with recommendations from the results of the Legionella risk assessment.

• The practice had carried out a review of all recruitment files and ensured they had the relevant checks needed prior to a new member of staff commencing. When needed a risk assessment had been carried out to demonstrate why a Disclosure and Barring Service (DBS) check was not required.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 October 2016

The practice is rated as good for people with long term conditions.

• The percentage of patients with diabetes whose last average blood glucose reading was acceptable was 83%, which is better than the Clinical Commissioning Group (CCG) and national averages of 78%. Exception reporting for diabetes indicators was 7%, compared to the CCG average of 14% and national average of 12%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 27 October 2016

The practice is rated as good for families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 82%, which was comparable to the Clinical Commissioning Group average of 81% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice had a playroom alongside the waiting area for young children.

Updated 27 October 2016

The practice was rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice performed in line with the Clinical Commissioning Group (CCG) and national averages for conditions commonly found in older people. For example, the percentage of patients with hypertension in whom the last blood pressure reading measured in the preceding 12 months was 150/90mmHg or less was 89%, which was comparable to the CCG average of 83% and national average of 84%.

Updated 27 October 2016

The practice is rated as good for working age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• Patients could book appointments via the telephone or online system.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 27 October 2016

The practice is rated as good for people experiencing poor mental health (including people with dementia)

• 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 90%. This was comparable to the national average of 90% and Clinical Commissioning Group average of 91%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and those living with dementia.

Updated 27 October 2016

The practice is rated as good for people whose circumstances may make them vulnerable.

• The practice had an arrangement in place to see patients at the practice that had no fixed abode.

• The practice had a register for vulnerable children, however not for those identified as vulnerable adults.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.