Cranleigh Medical Practice

We carried out an announced comprehensive inspection at Cranleigh Medical Practice on 7 August 2019 as part of our inspection programme.

We had previously carried out an announced comprehensive inspection at Cranleigh Medical Practice in October 2014. The practice was last rated as Good overall and Good in all domains with the exception of responsive and older population where they were rated as outstanding. The practice has now been rated good in these areas. However, this does not indicate a decline in the care being provided. As general practice has improved over time and previous outstanding practice has been incorporated into more standard care, what was previously considered outstanding has not remained so. All of the practices’ previous reports can be found by selecting the ‘all reports’ link for Cranleigh Medical Practice on our website www.cqc.org.uk

We carried out an inspection of this service due to the length of time since the last inspection. Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions:

• Is it Safe
• Is it Effective
• Is it Caring
• Is it Responsive
• Is it Well led

We have rated this practice as good overall and in all of the key questions. They have been rated as good overall for all population groups.

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 rated the practice good for providing safe, effective, caring, responsive and well-led care because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• 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-centre care.
• The care co-ordinator was proactive in identifying those patients who needed additional care. The Care coordinator phoned all patients over 65 who had been discharged from hospital. Any unmet needs, reviews or onward referrals were addressed during the call.
• The practice held a weekly meeting with the frailty lead GP, community matron and care coordinator to discuss all patients on a virtual ward. The virtual ward was made up of patients who had recently been discharged from hospital, contacted the ambulance service (SECAMB), been seen in A&E, been an inpatient for more than ten days, were in a community bed or patients that team members had concerns about.
• The practice has emergency on the day appointments with members of the duty team. The duty team consisted of a minor illness nurse, practice nurse, prescribing paramedic, GP registrars and foundation doctors (FY2). The duty team was supported by the duty GP.
• There was a clear leadership structure and staff felt supported by management.
• Staff worked well together as a team and all felt supported to carry out their roles. There was a strong team ethos and culture of working together for a common aim.

Whilst we found no breaches of regulations, the provider should:

• Continue to review and improve ways to increase uptake for cervical screening to be in line with Public Health England’s’ target of 80%.
• Review immunisation status for all staff and record in a central location

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