Archived: Dr Akundi & Partners Also known as Beech Grove Surgery

Updated 24 March 2017

Dr Loach & Partners also known as Beech Grove Surgery is located in converted premises at The Mall, Brading, Sandown, Isle of Wight, PO36 0DE.

This practice has a branch at Lake Surgery, 5 Sandown Rd, Sandown PO36 9JL. During this inspection we did not visit the branch.

Dr Loach & Partners has an NHS General Medical Services contract to provide health services to approximately 5000 patients in and around Brading, and surrounding area. The practice covers a mixed urban rural population and has a higher than national average for males and females aged 55 years and over.

Older people account for the largest group of registered patients at the practice. The practice identified the needs specific to this group and worked collaboratively with care homes, statutory and voluntary services to support the health and wellbeing of older people to meet a range of health and social needs. The practice is placed in the fifth least deprived level of deprivation.

The practice had car parking at the side of the building. There were consulting and treatment rooms on the ground floor. The waiting areas were clean and tidy and displayed a range of patient information boards and leaflets.

The practice has three GP partners, two male and one female. The practice has three practice nurses and one healthcare assistant.

The clinical team are supported by a practice manager and a team of seven receptionists and administration support staff.

The practice is open Monday to Friday 8:00am to 6:30pm and operates extended hours clinics on Tuesday evenings until 7.30pm and on Saturdays from 8am to 11am by appointment only. Phone lines are open from 8.30am to 6.30pm Monday to Friday (excluding public holidays). The practice closes for lunch between 1pm and 2pm but phone lines remain open.

Same day appointments can be booked at any time from 8.30am on the day patients need the appointment for.

Urgent appointments were also available for patients who needed them. Appointments could be made by phone, on line or by visiting the practice. The practice offered online booking for appointments and requesting prescriptions.

The practice offered telephone consultation appointments with the GP or nurses which could be arranged via the reception team. The practice also offered home visits if required and appointments with the practice nurses if the patient felt they did not need to speak with a GP.

The practice has opted out of providing out-of-hours services to their own patients and refers them to the Out of Hours service via the NHS 111 service.

Updated 24 March 2017

Letter from the Chief Inspector of General Practice

This inspection was an announced focused inspection carried out on Wednesday 1 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 13 April 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The full comprehensive report on the April 2016 inspection can be found by selecting the ‘all reports’ link for Dr Loach & Partners on our website at www.cqc.org.uk.

Overall the practice is now rated as Good.

At our previous inspection, we found that the practice had not ensured that:

• Following reports of safety incidents, reviews or investigations were thorough, recorded properly, discussed and lessons learned to support improvement were cascaded to the relevant staff.
• Practice policies were up to date such as for safeguarding and Disclosure and Barring Service checks.
• Water temperature checks were completed as recommended by a Legionella risk assessment that had been completed.

Our key findings at the inspection on 1 February 2017 were as follows:

• The practice now ensured that following reports of safety incidents, reviews or investigations are thorough, recorded properly, discussed and lessons learned to support improvement are cascaded to the relevant staff.
• Practice policies such as for safeguarding and Disclosure and Barring Service checks have been reviewed and updated.
• Water temperature checks were completed as recommended by the Legionella risk assessment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 July 2016

The practice is rated as good for the care of patients with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Diabetes indicators showed that 99% of patients with diabetes, on the register, had received influenza immunisation in the preceding 12 months, which was comparable to the national average of 95%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 5 July 2016

The practice is rated as good for the care of families, children and young patients.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice recorded that 82% of women aged 25-64 had a cervical screening test in the preceding five years, which is comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 5 July 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified patients at risk of emergency admission to hospital using both local knowledge and prepared care plans as appropriate and regularly reviewed admissions.
• The practice held monthly meetings with the a specialist end of life care nurse to identify on-going needs

Updated 5 July 2016

The practice is rated as good for the care of working-age patients (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice maintained a varied appointment mix with advanced booking (up to six weeks), 48 hour and same day / urgent appointments all of which were available for booking online. The practice encouraged the use of on line services to book appointments and request repeat prescriptions.
• There was an extended surgery on a Tuesday evening and on alternate Saturdays.
• The practice was in the process of setting up a virtual patient participation group forum which provided greater access to the group.

Updated 5 July 2016

The practice is rated as good for the care of patients experiencing poor mental health (including patients with dementia).

• 90% of patients diagnosed with dementia that had had their care reviewed in a face to face meeting in the last 12 months, which was higher to the national average at 85%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• Two GPs had completed specific training to support sectioning of patients with episodes of severe psychiatric illness. They also involved the expertise of a consultant in elderly psychiatry where there are more complex issues relating to mental capacity.

Updated 5 July 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.