We carried out an announced comprehensive inspection at St Paul’s Practice on 10 January 2019 as part of our inspection programme.
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 have rated this practice as good overall and good for all population groups, apart from for older people which we rated as outstanding.
We rated the population group of older people as outstanding due to the innovative approach the practice had taken with regard to management of leg ulcers, including the installation of foot sinks in its treatment rooms. The approach had led to improved healing rates and had reduced the recurrence of future leg ulcers.
We found that:
- 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.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- 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.
- We saw evidence of comprehensive clinical audits but the implementation of the recommendations from these audits was not consistently shown.
- The training of staff was encouraged but the documentation of completed staff training was not fully embedded.
- Staff at the practice felt supported and listened to by managers.
- Leadership at the practice was appropriately structured, strong and well-embedded.
Whilst we found no breaches of regulations, the provider should:
- Improve the identification of carers to enable this group of patients to access the care and support they need.
- Improve the process for the recording of completed staff training to include recent training modules.
- Review the practice’s programme for audits to drive improvement in clinical care.
- Continue to monitor the impact of changes in practice through the use of audits.
- Continue to improve the uptake for two-week wait cancer referrals and cervical screening to achieve the national target of 80%.
- Continue to review patient feedback in relation to accessing appointments.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice