Dr Shepherd & Partners Also known as The Filey Surgery

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service provided a safe environment. Areas for improvement had been identified, for example, replacement flooring in clinical rooms and examination couches and there was an action plan in place to address this. Facilities, equipment and technology were well-maintained and supported staff to deliver safe and effective care. Appropriate risk assessments and audits of the premises and infection, prevention and control were carried out and actions taken to mitigate risks. The service employed qualified, skilled and experienced staff to deliver safe services although they did not receive effective support and supervision. There had been a number of staff changes including partnership changes which staff told us had impacted on staff morale. The provider and recently successfully recruited to vacant roles and had a plan to be fully staffed by September 2024. Patients reported that they were able to access an appointment. Recruitment checks were carried out in accordance with regulations. Staff training was appropriate and mostly up to date and we saw new staff had received an induction. However, not all staff had received an appraisal, there was no oversight of staff competency checks and staff did not receive formal clinical supervision. Medicines and treatments were safe and met patients’ needs. The provider was carrying out medicines audits to identify patients who required monitoring, for example, patients on high-risk medicines. There was a good system for the actioning and monitoring of national medicines alerts. However, the system to authorise non prescribing healthcare staff to administer medicines required review. The provider forwarded evidence immediately following the site visit that these had been reviewed and updated.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us they had the equipment they required to carry out their role. Leaders told us they had a plan to address areas identified on infection, prevention and control audits with regard to the premises, for example, replacement of the carpets in the clinical rooms when funding was available. They had implemented actions to mitigate risks in the interim.

We observed the premises to be clean and tidy. We observed appropriate confidentiality procedures were in place, the reception desk had a stand back sign with patients being seated away from the reception desk and clinical rooms we reviewed had either privacy curtains or doors that locked. Appropriate emergency medicines and equipment were available and we observed these were maintained in line with national guidance. We observed there were some clinical couches in the premises that were fixed to the walls. However, leaders told us staff had access to 7 clinical rooms with couches that were not fixed and 4 which raised and lowered. We did not see any couches in a state of disrepair.

The provider had appropriate health and safety policies in place. They carried out safety risk assessments and audits and we saw evidence actions were being taken to mitigate risks identified.

We did not receive any feedback from patients regarding their care and treatment or difficulty accessing an appointment. The latest National GP Patient Survey data available at the time of the site visit showed patients were happy with their experience of care and treatment and access to services. The service used the national Friends and Family test to gain patient feedback. We reviewed April 2024 data, they had received 4909 responses from patients with the majority stating that they were likely or very likely to recommend the service to friends and family with a lot of positive feedback about their care and treatment, access to an appointment and staff helpfulness. There were approximately 4 to 5 negative comments, mainly relating to the wait for a routine appointment.

The majority of staff told us they did not feel there were currently enough staff and there had been a lot of staff changes which had impacted on staff morale, though some commented this had started to improve with the introduction of department leads. Leaders told us there had been a lot of staff changes in the previous 6 months, including changes in the GP partnership with most of the staff changes being due to natural progression, for example, retirement. Leaders told us they had managed to successfully recruit to vacancies and would be at full compliment of GP staff by September 2024, in the interim they were using 2 regular locum GPs. Reception and healthcare assistant vacancy posts had recently been filled and staff were in their induction phase and there was an advert due to go out at the time of the site visit for a practice nurse vacancy. Staff told us they received the training they needed to do their role, although some staff reported they did not get enough time to do this at work. Leaders had a plan to introduce allocated time for training. Clinical staff told us they did not receive regular formal clinical supervision but did have access to GPs if they required support. Some non-clinical staff said they had not had a formal appraisal for some time.

The provider had appropriate recruitment processes in place. We reviewed 3 personnel files during the site visit and found appropriate recruitment checks had been carried out, including disclosure and barring (DBS) checks. Staff newly recruited had received an induction. We reviewed staff training records and found staff had received and were mostly up to date with mandatory training. Where there were gaps, for example, basic life support training, dates for these had been scheduled in. However, not all staff had received an annual appraisal with reception staff not having had one since 2019. We observed these had been scheduled in for July 2024. Nurse and advanced nurse practitioners told us they had access to GPs for support, however, there were no processes in place for staff to receive regular formal clinical supervision. There was no process or system in place to monitor staff competencies. Leaders told us these had been completed, however, there was no management oversight as leaders told us staff kept their own records, so staff were not supported with any areas that had been identified for improvement. There were regular staff meetings including clinical meetings and we saw minutes of these.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not receive any feedback from patients regarding not being appropriately involved in decisions about their medicines.

Staff and leaders told us they had systems and processes in place to support the safe prescribing of medicines. The practice employed a pharmacist and pharmacy technician who supported the GPs in the practice. Prescribing and medicines management were discussed regularly at clinical meetings.

As part of the site visit, we reviewed medicine optimisation within the practice, we did not review systems and processes in the dispensary. We observed the pharmacy team were carrying out regular clinical searches to identify patients, including those on high-risk medicines who required monitoring. We saw there was a system in place to identify patients who were due a medication review. We observed medicines to be stored appropriately and we observed emergency medicines and equipment to be appropriate and there were systems in place to monitor these in line with national guidance.

The provider had an effective system in place for managing national medicines’ alerts. There were appropriate arrangements for the safe management, use and oversight of controlled drugs. The practice had a policy in place for the management of medicines including repeat prescribing. There were good systems in place for the safe and effective management of clinical correspondence. Accurate and up-to-date information about people’s medicines was available, particularly when they moved between health and care settings. Patient specific directives were in place for healthcare assistant staff. However, directives to instruct non-prescribing healthcare staff when administering medicines were not in date or authorised. These documents were updated immediately following the site visit.

Staff carried out a number of regular audits to identify patients who were on medicines that required monitoring, including those on high-risk medicines. Actions were being taken to address these.