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Care Quality Commissionstethoscope

Inspection carried out on 15 June 2016
During a routine inspection
Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Littledown Surgery, Bournemouth on Wednesday 15 June 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • The practice were committed to working collaboratively with patients who had complex needs to ensure they received coordinated care. For example, one of the GPs provided a project to improve care for patients over the age of 75, in order to reduce hospital admissions and improve recognition of cognitive impairment. The project had reduced hospital admissions and had reduced the length of hospital stay.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, 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.
  • The practice had a proactive carers lead who had identified 3% of the practice population as carers. The ongoing support included carers coffee mornings, facilitation of outside speakers, carers health checks, links to local services for carers, and an annual newsletter of useful information.
  • The practice had actively sought feedback from patients and dementia specialists about the building which had resulted in changes in signage, flooring and seating. There were 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 was organised and had effective governance structures in place.
  • 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.
  • The practice demonstrated a strong, visible, person-centred culture and staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity. For example, the practice had been proactive in the care of patients with dementia.
  • Patients were truly respected and valued as individuals and were empowered as partners in their care. For example, the practice worked closely with a voluntary coordinator which had resulted in patients accessing befriending and transport services which increased social activity, reduced isolation and reduced the number of times the patient attended the practice for emotional support.

We saw an area of outstanding practice:

There was evidence of quality improvement which was used by the practice to improve services. For example, one of the GPs provided a project for patients over the age of 75 to improve care, reduce hospital admissions and improve recognition of cognitive impairment. The GP had performed two cycles of an audit which demonstrated avoidable hospital admissions dropped from 33% in 2014 to 22% in 2015. The audit also showed an increase in dementia diagnosis. For example, seven patients had been diagnosed in 2014 and this had increased to 16 patients in 2015. The audit also saw a 50% reduction in the duration of hospital stay.

Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice