20 October 2022
During a routine inspection
We carried out an announced comprehensive inspection at White Rose Surgery on 19 and 20 October 2022. Overall, the practice is rated as good, and as follows for the key questions:
Safe – good
Effective - good
Caring - good
Responsive - outstanding
Well-led - good
At the previous inspection in September 2015 the practice was rated as outstanding overall, with individual ratings of outstanding for providing effective and responsive services.
At this inspection, the practice has been rated as good for the provision of effective services and and outstanding for the provision of responsive services. Effective is rated as good because since the 2015 inspection some elements recognised as outstanding have been mainstreamed into general practice nationally. Whilst the provider had maintained this good practise, the threshold to achieve an outstanding rating had not been reached for this key question.
We have rated responsive as outstanding due to the provision of a dedicated community long-term conditions nurse led service who dealt with the care of housebound patients, the delivery of enhanced screening for certain long-term conditions prevalent in the community, and high patient satisfaction levels in relation to services provided.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for White Rose Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this comprehensive inspection in line with our inspection priorities, due to the length of time since the last inspection.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting some staff interviews using video/telephone conferencing.
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A site visit to location.
- Reviewing completed staff questionnaires.
- Speaking with a patient and reviewing their feedback.
Our findings
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.
We found that:
- 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.
- There were systems in place to safeguard children and vulnerable adults from abuse. Staff we spoke with knew how to identify and report safeguarding concerns.
- There was a programme of quality improvement, this included clinical audit and monitoring prescribing performance.
- The practice supported staff development, and was an accredited training practice for GP trainees.
- Staff informed us that they had access to policies, procedures and guidance relevant to their role and responsibilities, this included clinical protocols and guidance.
- The provider had appropriate clinical equipment in place to enable the effective assessment of patients. The provider also had the necessary equipment and medicines available to deal with medical emergencies including emergency resuscitation equipment.
- The practice operated effective systems and processes to ensure good governance in accordance with the fundamental standards of care. Business planning had been undertaken and we saw that progress against this was monitored.
- The management team in the practice demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
- The practice hosted several staff from their Primary Care Network (PCN) who delivered services at the location and at other locations operated by the provider.
We saw an area of outstanding practice:
- The practice had developed a community long-term conditions service for housebound patients, staffed by a specialist nurse. We saw evidence which indicated that this, and the advanced care practitioner led acute home visiting service, had contributed to reduced attendances at local urgent and emergency care services.
Whilst we found no breach of regulations, the provider should:
- Make improvements to increase the uptake of cervical screening.
- Formalise clinical supervision practices for non-medical prescribers.
- Follow best practice guidance in the management and monitoring of people on high risk medicines, and those with long-term conditions.
- Establish the vaccination status of staff working in the practice in line with current guidance.
- Establish a patient participation group to improve patient engagement and feedback routes.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services