Letter from the Chief Inspector of General Practice
Old Bridge Surgery was inspected on Tuesday 24 February 2015. This was a comprehensive inspection. Overall the practice is rated as good.
Old Bridge Surgery provides primary medical services to people living in East Looe and the surrounding areas. The practice provides services to a homogeneous population and is situated in a rural coastal location. The practice had a General Medical Services (GMS) NHS contract to supply health services to the local population.
At the time of our inspection there were approximately 9,500 patients registered at the service with a team of 6 GP partners. There were three male and three female GPs. GP partners held managerial and financial responsibility for running the business. There were four nurses and four health care assistants at the practice. In addition there was a practice manager, and additional administrative and reception staff.
Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.
Our key findings were as follows:
We rated this practice as good. Patients reported having good access to appointments at the practice and liked having a named GP which improved their continuity of care. The practice was clean, well-organised, had good facilities and was well equipped to treat patients. There were effective infection control procedures in place.
The practice valued feedback from patients and acted upon this. Feedback from patients about their care and treatment was consistently positive. We observed a patient centred culture. Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Views of external stakeholders were positive and were aligned with our findings.
The practice was well-led and had a clear leadership structure in place whilst retaining a sense of mutual respect and team work. There were systems in place to monitor and improve quality and identify risk and systems to manage emergencies.
Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessment of a patient’s mental capacity to make an informed decision about their care and treatment, and the promotion of good health.
Suitable staff recruitment, pre-employment checks, induction and appraisal processes were in place and had been carried out. Staff had received training appropriate to their roles and further training needs had been identified and planned.
Information received about the practice prior to and during the inspection demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area.
Patients told us they felt safe in the hands of the staff and felt confident in clinical decisions made. There were effective safeguarding procedures in place.
Significant events, complaints and incidents were investigated and discussed. Learning from these events was communicated and acted upon.
We found an area of outstanding practice;
Patients with learning disabilities were offered and provided a health check every year during which their long term care plans were discussed with the patient and their carer if appropriate. The practice had supported one of the nurses to become a learning disability specialist. This nurse ensured all patients with learning disabilities had regular check ups. In addition, she had set up and led a group of volunteers to support patients with learning disabilities. This included organised field trips, activities and days out every three weeks. The practice had won a local award for outstanding contribution, as voted by patients in 2014.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice