Archived: Dr Faith Holdsworth Also known as The Fern Hill Practice

Updated 28 October 2014

Dr Faith Holdsworth is a GP practice situated in Faringdon, Oxfordshire. The practice occupies part of a purpose built building with another GP practice.

The practice provides a range of primary medical services to approximately 4,200 patients.

In addition to general medical services the practice offers child health screening and immunisation, family planning services, minor surgery, cervical smears, and chronic disease clinics for coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD) , diabetes, and hypertension.

In addition to the senior GP partner, patients are supported by two salaried GPs, two practice nurses, a health care assistant/phlebotomist and a phlebotomist. Clinical staff are supported by a practice management team, administration and dispensary staff.

The practice had a higher percentage of registered patients under 18 years of age than the average for England as well as the Oxfordshire CCG. The percentage of registered patients aged over 65 years was higher than the average for Oxfordshire CCG although lower than the average for England. The percentage of registered patients suffering deprivation was significantly lower than the average for England and lower than the Oxfordshire CCG average. The percentage of registered patients where income deprivation affected children was significantly lower than the average for England and lower than the Oxfordshire CCG average.

The practice had opted out of providing out of hours services to their own patients. There were arrangements in place for patients to access emergency care from an Out of Hours provider.

Services are provided from The Faringdon Medical Centre, Volunteer Way, Faringdon, Oxfordshire, SN7 7YU

Updated 28 October 2014

Dr Faith Holdsworth is a GP surgery with approximately 4,200 registered patients situated in Faringdon Oxfordshire. The practice provides a range of services for patients, which include clinics to manage long term conditions, minor surgery, family planning and child health.

The majority of patients we spoke with or received comments from, gave positive feedback about the practice and staff. We also spoke with the practice manager, a practice nurse, a health care assistant (HCA) and administrative staff. In addition to the senior GP partner, patients are supported by two salaried GPs, two practice nurses, a health care assistant/phlebotomist and a phlebotomist. Clinical staff are supported by a practice management team, administration and dispensary staff.

Although a safeguarding policy was in place for children and young people, there was no policy for safeguarding adults. Staff had not received specific safeguarding training and some did not fully understand the concept of safeguarding. Systems were not always in place to ensure patients were protected from the risks associated with medicines. Suitable arrangements were not in place for staff to receive appropriate appraisal. Recruitment procedures were not in operation. There was a lack of appropriate checks and a lack of risk assessment to determine if staff required a Disclosure and Barring Service (DBS) check. There was a lack of systems designed to enable assessment and monitoring of the quality of the services. The practice had not actively sought feedback from patients and regular audits had not been completed to check the quality of the service provided.

Patients were treated with dignity and respect. All of the patients we spoke with reported that they felt supported and well cared for. Staff demonstrated a compassionate and caring attitude and had built relationships with their patients.

We found that the practice was not meeting five of the Regulations in relation to; supporting workers, management of medicines, safeguarding patients from abuse, requirements relating to workers and assessing and monitoring the quality of service provision.

The practice provided for the needs of older patients through home visits and influenza vaccinations. Patients with long term conditions were provided for by a number of clinics aimed specifically at their needs. Mothers, babies and young children receive services including child health screening and immunisation. The needs of working age patients were recognised. A range of suitable appointments were available and telephone advice could be offered. Counselling was provided at the practice for patients with poor mental health.

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.

For this inspection we visited Dr Faith Holdsworth, The Farringdon Medical Centre, Volunteer Way, Faringdon, Oxfordshire, SN7 7YU.

Updated 28 October 2014

One of the practice nurses had completed a clinical audit in relation to diabetes management checks in conjunction with a training course. The audit confirmed that the checks were up to date. Staff understood the needs of patients and were able to respond to these. The practice offered specific services for people with long term conditions in the form of clinics. For example, coronary heart disease (CHD), diabetes and hypertension. Health promotion advice and information relating to specific health conditions was available at the practice. We were told of a recent example of a patient being given information about a national support group for diabetes. The practice website contained a section with information specifically aimed at people with long term conditions. This included information about Asthma, coronary heart disease CHD and diabetes and links to national support organisations. Home visits could be arranged which would be suitable for patients with long term conditions who had difficulty travelling to the practice. Some patients with long term conditions expressed concerns about a lack of consistency when they were unable to see the GP of their choice.

Updated 28 October 2014

The practice had a higher percentage of registered patients under 18 years of age than the average for England as well as the Oxfordshire Clinical Commissioning Group. The practice had a policy for safeguarding children and young people. A member of staff was able to explain how they had shared concerns about a child with a GP. However staff had not received any safeguarding training relating to children or young people. We received positive comments from the parent of a baby about the kindness, caring manner and attentiveness of the staff. Staff understood the needs of patients and were able to respond to these. A practice nurse told us of how they had raised a safeguarding issue in the past about a child with the GP and health visitor. The practice nurse also described a productive working relationship with the local school nurse. We were told of a recent example of a young person being consulted about the most appropriate way to receive Chlamydia test results. The parent of a baby told us how the nurse had referred them to a GP for an explanation about certain health issues. The practice provided child health screening and immunisation and a midwife was available for consultations at the practice for one morning a week. The practice website provided links to comprehensive information provided by NHS choices about pregnancy, childbirth and the care of babies.

Updated 28 October 2014

The percentage of registered patients aged over 65 years was higher than the average for Oxfordshire Clinical Commissioning Group although lower than the average for England. Home visits could be arranged which would be suitable for frail older people who had difficulty travelling to the practice. Arrangements were in place to provide influenza vaccinations appropriate to this group of patients. The practice website contained a section with information specifically aimed at older people. This included information about influenza vaccinations, healthy eating and exercise. The website also provided information about a local carers support group with links to further information for carers. This would have been useful for people with a caring role for older patients. We received positive comments from the relative of an older person about the care provided and the way staff treated the patient with kindness and in a caring manner. Level access was provided from the car park to the surgery waiting room suitable for older people with mobility problems. However we observed that some of these patients had difficulty entering the waiting area through the manually operated double doors.

Updated 28 October 2014

The practice offered early morning appointments on certain weekdays that were of benefit to patients of working age. One patient commented on how they had been able to arrange a lunchtime appointment to fit in with work commitments. Telephone advice could also be arranged for patients from GPs. We also found an example of recently retired patients being given information about a lunch club suitable for recently retired people. A range of information with appropriate links was provided for both male and female patients on the practice website. In addition self-help information was available on the website for minor illnesses such as coughs and colds.

Updated 28 October 2014

We were told of examples of how practice nurses had made referrals to the GP for counselling sessions for patients who may be experiencing mental health issues. In addition the health care assistant would refer patients within the practice where they found symptoms of potential poor mental health. One patient reported positive outcomes from a referral to another service relating to mental health following consultation with a GP at the practice. As well as information about the counselling service, the practice website provided links to mental health information for Oxfordshire. We were unable to check more specific information about patients with poor mental health with the GP. This included checking how the practice had responded to the Oxfordshire Clinical Commissioning Group priority around meeting the physical health needs of this patient group.

Updated 28 October 2014

The practice had no policy or procedure to guide staff in dealing with any safeguarding concerns relating to vulnerable adults. In addition staff had not received any specific training in safeguarding adults. We received positive comments from the relative of a patient with a learning disability about the care provided and the helpfulness of the staff at the practice. Information on the practice website suitable for this group of patients included information for carers and sexual health information.