The Care Quality Commission
  • Doctor
  • GP practice

Old Mill Surgery

Overall: Good read more about inspection ratings

Marlborough Road, Nuneaton, Warwickshire, CV11 5PQ (024) 7638 2554

Provided and run by:
Old Mill Surgery

All Inspections

11 January 2023

During a routine inspection

We carried out an announced comprehensive inspection at Old Mill Surgery on 11 January 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - good

Well-led - good

Following our previous inspection on 21 November 2017, the practice was rated good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Old Mill Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns reported to us.

Key questions inspected are services safe, effective, caring, responsive and well-led.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

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
  • information from the provider, patients, the public and other organisations.

We found that:

  • Patients mainly received effective care and treatment that met their needs. Processes were in place to monitor patients’ health in relation to the use of medicines including high risk medicines. However, patient records did not always contain sufficient documentation to reflect their review or consultation. Immediately following the inspection, we were informed the practice had revised the medicine review protocol to include guidance on documentation.
  • Safety alerts were received by the practice. A review of the patient record system found some patients required a review when prescribed a combination of medicines. The practice immediately contacted these patients and invited them in for a review.
  • Learning from significant events was evident. Actions were put in place to prevent recurrences.
  • Staff had received training to manage patients with long term conditions. Annual reviews were in place to check their health and medicines needs were being met.
  • The practice was slightly below the minimum target set by the UK Health Security Agency (UKHSA) for 3 out of 5 childhood immunisations. Specific clinics were in place twice a week to improve the uptake.
  • The published cervical cancer screening data showed that the practice had not met the target of 80% set by the UK Health and Security Agency. The practice had taken actions to improve the uptake of cervical screening.
  • Feedback from patients through the GP Patient Survey and the NHS Friends and Family Test was generally positive regarding the care and treatment they received.
  • The practice was suitable to meet the needs of patients with all services accessible on ground level.
  • Actions had been taken during the COVID-19 pandemic to keep people safe.
  • The practice had taken actions to ensure patients could access care and treatment in a timely way. This included changes to the telephone system and a capacity and demand analysis. Additional staff members had been recruited to support call taking at busy times.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care. However, we found areas where clinical oversight was not carried out effectively, which impacted on areas such as medicines management

We found 1 breach of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

  • Continue to take measures to improve the uptake of childhood immunisations and cervical screening.
  • Continue to identify and support patients who were carers.
  • Continue to take measures to improve patient satisfaction with access to the practice by the telephone.

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

21 November 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Old Mill Surgery on 21November 2017 as part of our inspection programme.

At this inspection we found:

  • Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
  • Urgent same day patient appointments were available when needed. All patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments and access care when needed.

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • Results from the July 2017 annual national GP patient survey showed high levels of patient satisfaction with all aspects of the practice and patient care.

  • Patients said GPs gave them enough time and treated them with dignity and respect.

  • The practice took the needs of the local population into account. For example, with an increased demand for patient access, the practice had developed the role of practice nurses. They had received additional training to enable them to manage patients with long term conditions to reflect this.

  • The practice had a dedicated telephone line for patients receiving end of life (palliative) care and their families and carers to use. This was also available when the practice was closed.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

11 August 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Old Mill Surgery on 11 August 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • Information about how to complain was available and easy to understand.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG). Changes had been made to the telephone system, with further changes planned so that patients had improved access to appointments.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The practice held an open evening at the practice at which stands were available providing information and guidance for patients on a range of topics such as Age UK, Guideposts, smoking cessation and a diabetic specialist team from the nearby George Eliot Hospital. Feedback from patients, agency representatives and staff was very positive and the practice planned to hold a further open evening over the winter period.
  • A range of support services was offered for younger patients. This included contraception advice; a website page with information specifically for younger patients; chlamydia screening with packs available in the waiting room for patients to collect; younger patient vaccination clinics with particular focus on university meningitis vaccinations; online appointments, prescribing and patient summary; and text messaging.

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

Importantly the provider should:

  • Ensure that their consent policy and procedure is followed specifically where the policy states that written consent should be obtained and recorded for invasive treatments.
  • Ensure that best practice guidance is followed that advises a nurse should be in attendance when GPs fit contraceptive devices.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice