This practice is rated as Good overall.
The key questions are rated as:
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Are services safe? – Good
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Are services effective? –Requires Improvement
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Are services caring? – Good
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Are services responsive? – Good
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Are services well-led? – Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
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Older People – Good
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People with long-term conditions – Good
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Families, children and young people – Good
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Working age people (including those recently retired and students – Good
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People whose circumstances may make them vulnerable – Good
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People experiencing poor mental health (including people with dementia) – Good
In 2017 three GP practices, known as Adcroft Surgery, Bradford Road Medical Centre and Widbrook Surgery merged, and changed their name to Trowbridge Health Centre. The surgery at Bradford Road has since been decommissioned. We inspected Adcroft Surgery (now Trowbridge Health Centre) in November 2016 and rated them as Good. We inspected Bradford Road Medical Centre in November 2016 and rated them as GoodWhen we inspected Widbrook Surgery in Dec 2015 we rated them as Inadequate and put them in to Special Measures. We did a follow up inspection in October 2016 and although we found improvements had been made, there were some on-going breaches of the regulations and at that time we rated them as Requires Improvement. The full reports of these previous inspections can be found by selecting the ‘all reports’ links for Trowbridge Health Centre and Widbrook Surgery on our website at www.cqc.org.uk.
This report covers the announced comprehensive inspection we carried out at Trowbridge Health Centre on 22 and 23 February 2018 as part of our inspection programme and to follow up on breaches of regulations we previously found at Widbrook Surgery, which is now a branch of Trowbridge Health Centre.
At this inspection we found:
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In the past year the practice had been through a period of significant change, we saw evidence the practice was working to develop one team culture from the three recently merged practices and to merge their systems and processes so they were the same across both sites.
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The practice had clear systems to manage risk so that safety incidents were less likely to occur. When incidents did occur, the practice learned from them and improved their processes.
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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Following the practice merger and moving into the new practice building, patients had found it difficult to access the appointments system. The practice took action to address this and patients we spoke to on the day of our inspection said they had found it easy to make appointments and were able to access care when they needed it.
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In some areas, such as staff training records, the practice had not completed the task of integrating the systems from the three recently merged practices.
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There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw two area of outstanding practice:
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The practice was proactive in providing additional services for patients with memory problems. They ran a memory café once a month at a local garden centre. It was promoted through leaflets in the surgery and on the practice website. Staff from the local Alzheimer’s charity usually attended. The service was led by two staff from the practice who arranged for speakers such as the local fire officer to attend. It was open to patients with memory problems and their carers.
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The practice ran a community cardiology unit that was led by one of the practice GP partners. There was a dedicated service suite that offered echocardiograms, exercise tolerance tests and 24 hour ECG monitoring. This meant that patients needing this service avoided travel to the nearest hospital.
There was one area where the provider must make improvements:
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The provider must ensure they maintain adequate records in relation to persons employed. Specifically, the practice systems did not ensure that all staff had received the training they considered essential for their role.
The areas where the provider should make improvements are:
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Improve the uptake of cervical screening.
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Review their exception reporting for mental health criteria within the the Quality Outcome Framework, which were above the national average. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate.)
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Review staff knowledge of how to access meetings minutes on the practice IT system.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice