Archived: Catherine Street Surgery

Updated 19 February 2015

The practice is located in the centre of Whitehaven. The practice covers the area of Whitehaven and the areas that immediately surround it on the West coast of Cumbria. The practice provides services from the following address and we visited here during this inspection:

3 Catherine Street, Whitehaven, Cumbria, CA28 7PD.

The practice is based in a two storey building. A disabled parking bay is located directly in front of the practice building and the practice also offers wheelchair access and a WC that can be accessed by all patients. On-site parking for patients is not provided. The practice provides services to just over 2,700 patients of all ages based on a General Medical Services (GMS) contract agreement for general practice.

The practice has two GP partners (both female) and uses a regular locum GP (male) one day per week. The practice also employs two practice nurses, one health care assistant, a practice manager and a team of administrative, reception and support staff.

The service for patients requiring urgent medical attention out-of-hours is provided by Cumbria Health on Call (CHoC).

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We inspected Catherine Street Surgery on 13 November 2014 and visited the surgery in Whitehaven. We inspected this service as part of our comprehensive inspection programme.

Overall, we rated the practice as good, although there were some areas where the practice should make improvements. Our key findings were as follows:

• Patients reported good access to the practice, with urgent appointments available the same day.
• Patients said, and our observations confirmed, they were treated with kindness and respect by staff who worked in the practice
• Patient outcomes were generally at the average for the locality and good practice guidance was referenced.
• The practice was visibly clean and tidy.
• The practice learned from incidents and took action to prevent a recurrence.

We saw the following area of outstanding practice:

• The practice employed a co-ordinator to work with patients who were at risk of falls. The co-ordinator focused on patients who did not have input from other clinical services, for example Community Matrons or District Nurses. These patients were generally housebound and not regular attenders of the practice. The co-ordinator completed an assessment of their needs. If it was identified patients could benefit from changes to daily living, the co-ordinator would facilitate the change by working with other agencies. Re-assessments of people’s need would be completed by the co-ordinator after an agreed time to measure the impact of any changes made.

However, there were also areas of practice where the provider should make improvements.

• Patients were kept waiting in the practice to see a GP up to one hour beyond their allotted appointment times. We also found it was difficult for patients to get an appointment with the male (locum) GP or the GP of their choice, as their appointments were frequently fully booked.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these 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, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 February 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 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 people were treated in an age-appropriate way 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 19 February 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 dementia and 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. The practice employed an elderly care co-ordinator who provided support, social contact and facilitated input from other agencies for patients who were not otherwise accessing services.

Updated 19 February 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The age profile of patients at the practice is mainly those of working age, students and the recently retired. The practice did not offer extended opening hours for appointments. Patients could request repeat prescriptions and cancel appointments online, however they could not book appointments online. The practice offered a range of health promotion and screening that reflected the needs for this age group. Health promotion advice and material was available through the practice and on its website.

Updated 19 February 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 patients experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice provided information and told patients experiencing poor mental health about how to access various support groups. It 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. Staff had received training on how to care for patients with mental health needs and dementia.

Updated 19 February 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 and longer appointments were available on request.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable peoples’ care and treatment. 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.