Archived: New Inn Surgery

Updated 11 November 2016

Letter from the Chief Inspector of General Practice

New Inn Surgery was placed into special measures following an inspection in October 2014. In order to establish if the required improvements had been made we completed a further comprehensive inspection in October 2015. Improvements to the delivery of service were evident and the practice was rated as good overall, however was rated as requires improvement for delivering safe services.

After the October 2015 comprehensive inspection, the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

• complete regular fire drills.
• record the appropriate action taken if fridge temperatures were recorded above the recommended temperature range.
• ensure that all medicines needed to deal with emergencies were readily available.
• ensure a child oxygen mask was available.
• ensure that safe processes were in place for the management of hand written blank prescriptions.
• ensure patients notes were securely stored.

In addition the provider should:

• record when the defibrillator has been checked

We undertook this announced focused follow up inspection on 14 October 2016 to check that the provider had followed their action plan and to confirm that they now met legal requirements. The outcome of this inspection found tht the provider was now meeting all requirements and is rated as good under the safe domain.

This report only covers our findings in relation to those requirements. We found:

• the practice had completed a fire drill in November 2015 and October 2016 and new smoke detectors had been installed.
• there were processes in place to ensure fridge temperatures were monitored. All staff were aware of these and the actions to take should an error occur.
• medicines and equipment to use in an emergency were readily available including the availability of a child oxygen mask.
• safe processes were in place for the management of hand written blank prescriptions
• patient’s notes were stored securely.

In addition we saw evidence that the provider had:

• undertaken and recorded monthly checks of to ensure the defibrillator was in good working order.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 December 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medicine needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 24 December 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 24 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered continuity of care with a named GP. Elderly patients with complex care needs and those at risk of hospital admission all had personalised care plans that were shared with local organisations to facilitate the continuity of care. For example, patients who had dementia and those who required end of life care. It was responsive to the needs of older people, and could offer daily visits to elderly housebound patients where necessary and rapid access appointments for those with enhanced needs. We saw evidence that the practice was working to the Gold Standards Framework for those patients with end of life care needs. The practice participated in the enhanced service for dementia that facilitated diagnosis and support for patients with dementia.

Updated 24 December 2015

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 24 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients with severe mental health needs had care plans and received physical health checks. The practice offered continuity of care with a named GP for this population group. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations, and liaised closely with counselling services. Staff had received training on how to care for people with mental health needs and dementia. The practice participated in the enhanced service for dementia that facilitated diagnosis and support for patients with dementia.

Updated 24 December 2015

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 those with a learning disability. The practice offered continuity of care with a named GP for this population group. It offered longer appointments and carried out annual health checks for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients 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.