Archived: Bentley Village Surgery

Updated 9 September 2016

Bentley Village Surgery is situated in a rural village of Farnham. The practice is a single storey building with good access for patients with limited mobility. The practice has approximately 3382 patients on its register. The practice also has a dispensary on site. The practice is able to provide dispensing to look services to those patients who lived more than one mile (1.6km) from their nearest pharmacy premises. The dispensary was open from 8:30am to 12:30pm and 4pm to 6.30pm for patients to collect their prescriptions. The practice holds a General Medical Services contract.

The practice is situated in one of the least deprived areas of the country and the majority of patients describe themselves as White British. The practice has higher numbers of female patient aged 85 years and older, when compared with the England average. There are also higher numbers of patient aged 45 to 74 years; and patients aged 5 to 14 years.

There are four GPs, one of whom is male and three who are female; and two practice nurses. The clinical team are supported by a practice manager and a team of reception and administration staff. The dispensary is staffed by a dispensary manager and five staff.

The practice is open between 8am and 6.30pm daily, Monday to Friday. Appointments with GPs and practice nurses are available between these times. When the practice is closed patients are advised to contact the out of hours service via the NHS 111 service.

We inspected the only location at:

Hole Lane

Farnham

Hampshire

GU10 5LP

Updated 9 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bentley Village Surgery on 28 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows: There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review recruitment processes and personnel files to check that there is a full employment history for each member of staff.

• Review arrangements for business continuity in the event of an interruption to service provision.

• Review training provision to determine what the practice considers is mandatory and formalise this in a policy.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 9 September 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice had a dedicated team of a GP and practice nurse to focus on management and care of patients with diabetes.

• Diabetes indicators were similar to clinical commissioning group (CCG) and national averages. For example, a total of 95% of patients hada foot examination in the previous 12 months; compared with the CCG average of 90%; and the national average of 88%.

• 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 9 September 2016

The practice is rated as good for the care of 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 81%, which was comparable to the CCG 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.

• We saw positive examples of joint working with midwives and health visitors.

Updated 9 September 2016

The practice is 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 carried out regular visits to older patients who lived in care homes.

• All older patients had been allocated and informed of their named GP.

Updated 9 September 2016

The practice is rated as good for the care of 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.

• 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 9 September 2016

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia).

• 84% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive agreed care plan, this was comparable to national averages.
• 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 carried out advance care planning for patients living with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and those living with dementia.

Updated 9 September 2016

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

• The practice held a register of patients living in vulnerable circumstances including homeless patients, travellers and those with a learning disability.

• 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.