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Haughton Thornley Medical Centres Good

Inspection Summary


Overall summary & rating

Good

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thornley House Medical Centre on 28 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring, responsive and safe services. It was also good for providing services for the populations groups we rate.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Risks to patients were assessed and well managed.
  • 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.
  • 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, however there was no evidence of the system being put into practice.
  • Patients provided varied feedback on accessing appointment, with a number of patients reporting difficulties getting through to the practice by telephone, however patients reported when they got appointments these were convenient.
  • 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.

We saw several areas of outstanding practice including:

  • The practice offered patients direct electronic access to their health records enabling them to routinely read their own health records by logging on to an electronic system from home with a user name and password. To date 35% of patient have signed up to allow them access to their records.
  • One GP provided dry needling a treatment similar to acupuncture for patients during consultations to provide pain relief and assist injury rehabilitation where required as an alternative or in addition to medication.

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

Importantly the provider should

  • Ensure recruitment checks are carried out in line with practice policy.
  • Ensure all staff have access to appraisals on an annual basis.
  • Ensure data sheets and risk assessments are carried out for Control of Substances Hazardous to Health (COSHH).
  • Ensure checks are recorded for the cleaning of clinical equipment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 June 2015

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Lessons were learned and communicated via team meetings to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were enough staff to keep patients safe.

Effective

Good

Updated 11 June 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were the same or above average for the locality. Staff referred to guidance from National Institute for Health and Care Excellence and used it routinely. Patient’s needs were assessed and care was planned and delivered in line with current legislation. Staff had received training appropriate to their roles and any further training and updates had been identified and appropriate training planned to meet these needs. There was evidence of appraisals and personal development plans for clinical staff however appraisals were out of date for non clinical staff. Staff worked with multidisciplinary teams.

Caring

Good

Updated 11 June 2015

The practice is rated as good for caring. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them. We also saw that staff treated patients with kindness and respect ensuring confidentiality was maintained.

Responsive

Good

Updated 11 June 2015

The practice is rated as good for responsive. The practice reviewed the needs of their local population and engaged with the NHS England Area Teams and Clinical Commissioning Group (CCG) to secure service improvements where these were identified. Patients reported good access to the practice with urgent appointments available the same day. The practice had good facilities and was well equipped to treat patients and meet their needs. There was an accessible complaints system with evidence demonstrating that the practice responded quickly to issues raised.

Well-led

Good

Updated 11 June 2015

The practice is rated as good for well-led. The practice had clear aims to deliver good outcomes for patients. Staff were clear about the aims and their responsibilities in relation to the practice. There was a clear leadership and staff felt supported by management. The practice had a number of policies and procedures to govern activity. There were systems in place to monitor and identify risk. The practice sought feedback from staff and patients and this had been acted upon. Staff had received inductions, regular performance reviews and attended staff meetings.

Checks on specific services

Older people

Good

Updated 11 June 2015

The practice is rated as good for the population group of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia, shingles vaccinations and end of life care. The care for patients at the end of life was in line with the Gold Standard Framework.

The practice was responsive to the needs of older people, the GPs and nurses provided home visits and appointments for those in residential or nursing homes, with rapid access appointments for those with enhanced needs.

Working with other practices in the locality and New Charter Housing the practice have access to a full time Healthy Living Project Link worker for patients over 75, patients can be referred to the project where assessment take place to look at medical, social and psychological problems. Initial outcomes for patients have included many patients discovering local groups, and support with amenities such as telephones.

The practice had achieved 76% vaccination rate for the influenza vaccine for those over 65, just above the local average.

People with long term conditions

Good

Updated 11 June 2015

The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. The practice has an electronic register of patients with long term conditions and has a recall system in place to ensure patients are called for a review annually so their condition could be monitored and reviewed.

The national Quality Outcome Framework (QOF) 2013/14 showed 100% of the outcomes had been achieved for patients with asthma and for patients with Chronic obstructive pulmonary disease (COPD) above the local CCG and national average.

For those people with the most complex needs GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 11 June 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-up vulnerable families and who were at risk.

Immunisation rates were high for all standard childhood immunisations.

Appointments were available outside of school hours for children and all of the staff were responsive to parents’ concerns and would ensure parents could have same day appointments or telephone consultations for children who were unwell.

Working age people (including those recently retired and students)

Good

Updated 11 June 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). The practice offered online services as well as a full range of health promotion and screening which reflects the needs for this age group. Patients were provided with a range of healthy lifestyle support including smoking cessation. The practice offered NHS health checks to patients including elderly health checks to patients who are 60 plus and not reached the age of 75. Appointments could be booked online in advance and a text message reminder system was in place to remind patients of pre booked appointments.

The practice provided contraception and sexual health service for patients and actively referred patients to specialist service such as genital-urinary medicine (GUM).

People whose circumstances may make them vulnerable

Good

Updated 11 June 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice had carried out annual health checks for people with learning disabilities and offered longer appointments for people where required. For patients where English was their second language, an interpreter could be arranged.

The practice worked with multi-disciplinary teams in the case management of vulnerable people.

Staff knew how to recognise signs of abuse in vulnerable adults and children.