Old Catton Medical Practice

Updated 7 December 2018

The practice is situated in Old Catton, Norwich, Norfolk. The practice offers health care services to approximately 7,400 patients. The practice holds a General Medical Service (GMS) contract with the NHS Norwich Clinical Commissioning Group.

There are two GP partners (one female, one male) who are supported by one salaried GP (male). There are two practice nurses, one nurse practitioner and two healthcare assistants. A team of six administration and reception staff support the business team, comprised of a practice manager, a patient services manager, a reception manager and a practice support coordinator.

The practice is open between 8am to 6pm Monday to Friday and closes for lunch between 12.30pm and 1.30pm daily. Extended hours are offered on Monday morning from 7am and on Wednesday and Thursday mornings from 7.30am. If the practice is closed, patients are asked to call the NHS111 service or to dial 999 in the event of a life-threatening emergency. Out of hours services are provided by Integrated Care 24.

The practice has a lower number of patients aged 20 to 24 years and a higher number of patients aged 35 to 39 years compared to the local and national average. However, the practice population profile generally follows the national average. The deprivation score is below the England average. Income deprivation affecting children and older people is below national averages. Male and female life expectancy in this area is in line with the England average at 82 years for men and 84 years for women.

Updated 7 December 2018

We carried out an announced comprehensive inspection at Old Catton Medical Practice on 29 January 2018. The overall rating for the practice was good, with a requires improvement rating for providing safe services. We issued a requirement notice against regulation 17 of the Health and Social Care Act Regulations 2014 Good governance, as the practice did not have effective systems for managing safety alerts and pathology results in a timely way.

We also identified areas the practice could improve and should:

• Review the use of information technology systems to drive improvement, including coding suspected cancer referrals and the templates used to record care and treatment for palliative care patients.
• Provide timely annual reviews for patients with learning difficulties.
• Monitor and review patient survey results and respond accordingly.

The full comprehensive report on the January 2018 inspection can be found by selecting the ‘all reports’ link for Old Catton Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 15 November 2018 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 29 January 2018.

This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

Overall the practice is now rated as good, with a good rating for providing safe services.

At this inspection we found:

• Systems and processes were reviewed and improved to effectively manage safety alerts and pathology results.
• The system for coding suspected cancer referrals was reviewed and improved and the recording template for palliative care templates was effective in record all necessary information.
• The practice reviewed their list of patients with learning difficulties and increased the numbers of structured annual reviews completed. We also saw that patients who had not yet had an annual review were scheduled to have one.
• The practice had also reviewed the latest GP patient survey data and were taking action to improve the results, including commissioning a telephone system audit, increasing GP staffing levels, increasing telephone answering capability during busy periods.

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

Please refer to the detailed report and the evidence tables for further information.

Updated 29 October 2015

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, staff worked with relevant health and care professionals to co-ordinate and deliver a multidisciplinary package of care.

Updated 29 October 2015

The practice is rated as good for the care of families, children and young people. 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 people on the safeguarding register. Immunisation rates were in line with local averages for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 29 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in 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 end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 29 October 2015

The practice is rated as good for the care of working-age people (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 was proactive in offering online and telephone services as well as a full range of health promotion and screening that reflects the needs for this age group. The practice offered extended opening hours on four weekday mornings per week. This benefitted people who were unable to attend the practice during working hours.

Updated 29 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. During 2014/2015 the practice confirmed 38 out of 44 patients with dementia had a care plan in place.

Staff received training on how to care for people with mental health needs and dementia. Staff had a clear understanding of the 2005 Mental Capacity Act and their role in implementing the Act. The practice signposted and supported patients experiencing poor mental health 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 (A&E) where they may have been experiencing poor mental health.

Updated 29 October 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks for people with a learning disability. Since April 2015, 11 out of 18 patients with a learning disability had a received a health check and had a care plan in place. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.