Puddletown Surgery

Updated 31 May 2016

Puddletown Surgery is a purpose built dispensing GP practice situated in Puddletown, a village close to Dorchester, Dorset. It has been at its present location since 2011.

The practice has an NHS general medical services contract to provide health services to approximately 4,100 patients in Puddletown and the surrounding villages. The practice area is not ethnically diverse; unemployment is low and has no specific areas of deprivation.

The practice has two male GP partners and one female salaried GP who together provide care equivalent to just over 2 full time GPs. The practice is a training practice for doctors training to be GPs. Puddletown Surgery also employs four primary care nurses and a health care assistant as well as dispensary staff. The practice is supported by a team of managerial and administration staff who carry out administration, reception, scanning and secretarial duties.

A range of additional services are offered by the practice such as chiropody, counselling and minor injury advice.

The practice is open from 8.30am to 6.30pm from Monday to Friday and between 8.30am and 11.00am on Saturdays. The practice offers on-line services for patients such as appointment booking and ordering repeat prescriptions. The practice has opted out of providing out-of-hours services to their own patients and refers them to South Western Ambulance Trust via the NHS 111 service.

We previously inspected Puddletown Surgery on 5 August 2015. Following this inspection, the practice was given an overall rating of good. A copy of the report detailing our findings can be found at www.cqc.org.uk

Updated 31 May 2016

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Puddletown Surgery on 3 May 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at Puddletown Surgery on 5 August 2015 when we rated the practice as good overall. The practice was rated as requires improvement for providing safe care. This was because medicines kept in the treatment rooms and the practice dispensary were secure but the keys to these areas were not. The Standard operating procedures for the dispensary were not signed by all relevant staff. Also recruitment procedures were incomplete.

We asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time. The practice was able to demonstrate that they were meeting the standards. The practice is now rated as good for providing safe care. The overall rating remains as good.

This report should be read in conjunction with the full inspection report.

Our key findings across the areas we inspected were as follows:

• Arrangements were in place for the management for security of medicine keys

• The dispensary standard operating procedures were in place and appropriately signed by staff

• Recruitment checks for staff had been appropriately completed and recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 October 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. Patients who had been identified as having a long term condition had a named GP and a structured annual review to check that their health and medication needs were being met. Review of all chronic conditions were carried out at a single appointment which reduced unnecessary appointments and followed latest guidelines. 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 22 October 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 on 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 high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw examples of joint working with midwives, health visitors and school nurses. A health visitor, based at the practice held a baby clinic every week.

Updated 22 October 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 proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 22 October 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 that it was accessible, flexible and offered continuity of care to this group. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for his age group.

Updated 22 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations and a psychiatrist held a clinic on site one afternoon per month. It had a system in place to follow up patients who attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 22 October 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 homeless people, travellers and those with a learning disability. Every year patients who had a learning disability were invited to a review examination. Assessments were carried out with a carer if necessary either at the practice, the patient’s home or residential care home. The practice also offered longer appointments for this population group.

Patients who were identified as vulnerable had their records highlighted so that staff were aware of their needs and attention. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It told vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Practice leaflets were available in easy read format. 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.