The Courtyard Surgery

Background to this inspection

Updated 2 October 2017

The Courtyard Surgery is a GP practice based in Horsham in West Sussex, providing primary medical services to 8,900 (18,000 in total combined with Riverside Surgery) patients. In October 2016 the practice joined with Riverside Surgery and is managed together as a single, two site practice. However, each practice has retained their own patient lists but services were accessible to patients across both sites.

The practice patient population is made up of a higher than average proportion of patients in work or education and lower levels of unemployment. There was a slightly higher than average proportion of patients with a long standing health condition. The practice had a slightly smaller proportion of elderly patients and fewer children under the age of 18. The deprivation score for the practice area was slightly higher than the CCG average but significantly lower than the national average.

The practice holds a General Medical Service contract and is part of NHS Horsham and Mid Sussex Clinical Commissioning Group. The practice consists of four GP partners (male and female) and two salaried GPs. The GPs are supported by a practice manager, two practice nurses a healthcare assistant, an assistant practice manager at each site, and an administrative team. A wide range of services and clinics are offered by the practice including asthma and diabetes.

The Courtyard Surgery is open between 8.30am to 6pm on Monday to Thursday and between 8.30am and 4pm on a Friday. Telephone lines are open from 8am to 6.30pm Monday to Friday. Extended hours appointments are available until 8pm on a Monday evening and between 8.30am and 1pm on a Saturday. Riverside surgery is open between 8am and 6.30pm Monday to Friday with appointments until 7pm on a Monday. In addition, appointments that could be booked up to four weeks in advance, urgent appointments were also available for patients that needed them.

The practice has opted out of providing Out of Hours services to their patients. There are arrangements for patients to access care from an Out of Hours provider (111).

Services are provided from:

The Courtyard Surgery, 56 London Road, Horsham, West Sussex, RH12 1AT.

And also from:

Riverside Surgery, 48 Worthing Road, Horsham, West Sussex, RH12 1UD.

We did not inspect Riverside Surgery as part of this inspection.

Overall inspection

Good

Updated 2 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Courtyard Surgery on 17 January 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for The Courtyard Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 24 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 17 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

Significant events were discussed at practice meetings. The outcomes and learning from these meetings was shared with staff.
Systems were now in place for receiving and disseminating information on patient safety alerts.
Staff appraisal records now included continual professional development records.
Training and induction records for clinical and non-clinical staff were in place and up to date. Gaps in training had been addressed.
Systems were in place to record, respond to and learn from complaints and concerns.

Additionally:

The practice had reviewed the low patient satisfaction scores in respect of involving patients in decisions. We were told that GPs had taken on this feedback and were aware of the need to ensure patients were involved and treatments explained. We saw draft advice leaflets being developed by the practice to assist with explaining test results. The last patient survey showed that 87% of respondents stated the last GP they saw was good at involving them in decisions compared to the previous survey result of 76%.
The practice reviewed their carers list and undertook an exercise to ensure all known carers were identified as carers in the clinical system. The practice manager told us that every opportunity was taken to check carer status. For examples patients were asked at the point of registration, during self-check-in and appointments. The current figure was 0.9% of the practice population. The practice had a care co-ordinator who kept this under review.
The practice had reviewed their approach to bereavement and a protocol had been put in place with a copy on display in the reception area. GPs made contact with the family or carers and where appropriate a letter of condolence was sent.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

Review the current arrangements for storing information on complaints to ensure this is readily available for review.
Review the arrangements for transferring data between the two practices to ensure this meets data protection and information governance policies.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice