Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Padiham Group Practice on 13 September 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
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The practice used innovative and proactive methods to improve patient outcomes, this included developing a community interest company project which ran from 2011 to 2015 called the Green Dreams Project which provided local, community-based solutions in East Lancashire to unemployment, isolation and reduced quality of life.
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There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
- Many risks to patients were assessed and managed. However we found systems and processes to fully support risk management were not consistently in place.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. There were gaps in training records which did not consistently ensure all staff had knowledge and experience to deliver effective care and treatment.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- Despite ongoing building work, the practice had good facilities and was well equipped to treat patients and meet their needs.
- 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 provider was aware of and complied with the requirements of the duty of candour.
We saw one area of outstanding practice in the development of a local community interest company:
The practice, in particular the lead GP, had led and developed the community interest company the Green Dreams Project to improve support for patient wellbeing. This recognised that some health issues are affected by social situations and set in place support to help people identify their strengths and overcome problems including social isolation, employment and community engagement. Between 2011 and 2015, this service received funding from East Lancashire Primary Care Trust, later East Lancashire Clinical Commissioning Group (CCG) and the University of Central Lancashire undertook an evaluation of the impact of the project. The success led to the service being rolled out throughout East Lancashire to 20 GP surgeries in seven towns. The service received 1,000 referrals annually for wellbeing support.
Although the funding for the Green Dreams Project ended in December 2015 when a new well-being service was commissioned by Lancashire County Council, the practice remained committed to developing a social prescribing model for the local area and also working with partners to develop new local services for patients.
The Green Dreams Project also developed the local community nursing team which provided advanced practitioner nursing for 17 practices in the Burnley locality and took the lead in the development of the local integrated neighbourhood team which bought together health and social care professionals to ensure the most complex patients were given appropriate health and social care support. This advanced practitioner nursing team continued to provide services with funding from the CCG.
The areas where the provider must make improvement are:
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The practice must ensure that all potential risks to patients and staff are adequately assessed and appropriate systems put in place to manage risks.
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The practice must ensure that vaccine storage fridge temperatures are checked and recorded on a daily basis and that staff checking fridges are adequately trained and aware of the regulations for vaccine storage.
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The practice must complete actions to ensure safeguarding is prioritised to include standardising coding for safeguarding concerns, maintaining accurate safeguarding registers, regular liaison with health visitors and appropriate safeguarding training for all staff.
- Improve the recording and monitoring of staff training to demonstrate that all staff are in date with mandatory training and specialist skills training.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice