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Archived: Salford Health Matters Little Hulton Good

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Inspection Summary


Overall summary & rating

Good

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Salford Health Matters Little Hulton on 08 December 2015. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

  • The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.

  • Feedback from patients about their care was consistently and strongly positive.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
  • The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

  • The practice had a vascular long term conditions management process system. This allows the practice to provide a holistic review for patients with multiple vascular conditions.

  • The practice had a children’s service which was known as The Salford Children’s Community Partnership. This was a service that allowed parents to take sick children that presented with acute symptoms to the practice for treatment and advice. The service had facilities to admit children and monitor them for a period of time and this service was open to five other GP surgeries across the Little Hulton area.

  • The practice worked closely with City West Housing Trust and assisted in identifying houses that may pose as health risks to tenants due to damp issues.

  • There was a strong focus on staff professional development. All staff received 360 degree feedback regardless of what level they were within the organisation, and all staff had received dementia awareness training.

  • The practice was in the process of setting up a ‘virtual ward’ for improving the care of older patients. Patients would be contacted by telephone each day. The virtual ward was able to offer a chronic long term condition management plan, as well as a physiotherapy management plan. Home visits could also be arranged depending on the health needs of the patient.

  • The practice is a participator in the ‘Safe haven’ scheme which is for patients that have been previously removed from primary care due to an incident of violence. The scheme is designed to help rehabilitate patients back into primary care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 February 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events

  • The practice used every opportunity to learn from internal and external incidents, to support improvement. Learning was based on a thorough analysis and investigation.

  • When there are unintended or unexpected safety incidents, people receive reasonable support, truthful information, a verbal and written apology and are told about any actions to improve processes to prevent the same thing happening again.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed.

Effective

Outstanding

Updated 11 February 2016

The practice is rated as outstanding for providing effective services.

  • Our findings at inspection showed that systems were in place to ensure that all clinicians were up to date with both National Institute for Health and Care Excellence (NICE) guidelines and other locally agreed guidelines.

  • We also saw evidence to confirm that these guidelines were positively influencing and improving practice and outcomes for patients. This was demonstrated in the practice being able to provide a holistic approach to patients with vascular conditions using the vascular conditions management system.

  • Data showed that the practice was performing highly when compared to neighbouring practices in the Clinical Commissioning Group. Quality Outcome Framework indicators for diabetes, mental health and dementia were all above the CCG average.

  • The practice used innovative and proactive methods to improve patient outcomes and working with other local providers to share best practice.

  • There was evidence of appraisals and personal development plans for all staff.

Caring

Good

Updated 11 February 2016

The practice is rated as good for providing caring services.

  • Data from the National GP Patient Survey showed patients rated the practice slightly below the national average for several aspects of care.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • We observed a strong patient-centred culture.

Responsive

Good

Updated 11 February 2016

The practice is rated as good for providing responsive services.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
  • There are innovative approaches to providing integrated person-centred care.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
  • People can access appointments and services in a way and at a time that suits them.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and easy to understand, and the practice responded quickly when issues were raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 11 February 2016

The practice is rated as good for being well-led.

  • It had a clear vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
  • High standards were promoted and owned by all practice staff and teams worked together across all roles.
  • Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice.
  • The practice carried out proactive succession planning.
  • There was a high level of constructive engagement with staff and a high level of staff satisfaction.
  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.
  • There was a strong focus on continuous learning and improvement at all levels. All staff received 360 degree feedback, regardless of their position within the organisation.
Checks on specific services

People with long term conditions

Outstanding

Updated 11 February 2016

The practice is rated as outstanding for the care of people 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.
  • 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 medicines 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.
  • The practice had a vascular long term conditions management process system. This allows the practice to providing a holistic vascular review for patients with multiple vascular conditions.

Families, children and young people

Outstanding

Updated 11 February 2016

The practice is rated as outstanding 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 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.
  • The practice had an administration lead for safeguarding who was responsible for ensuring the practice had an up to date list of all 'to watch' children, and children on protection plans.
  • We saw good examples of joint working with midwives, health visitors and school nurses. The practice had a children’s ward which was known as The Salford Children’s Community Partnership. This was a service that allowed parents to take sick children that presented with acute symptoms to the practice for treatment and advice. The service had facilities to admit children and monitor them for a period of time and this service was open to five other GP surgeries across the Little Hulton area. This had led to a 40% reduction in acute paediatric admissions into A&E from patients at the Little Hulton practice.

Older people

Good

Updated 11 February 2016

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

  • The practice was in the process of setting up a ‘virtual ward’ for improving the care of older patients. Patients would be contacted by telephone each day. The virtual ward was able to offer a chronic long term condition management plan, as well as a physiotherapy management plan. Home visits could also be arranged depending on the health needs of the patient.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.
  • It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 11 February 2016

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 services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 February 2016

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

  • 82% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
  • 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.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
  • All staff had undergone dementia awareness training and had a good understanding of how to support people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 11 February 2016

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 homeless people, travellers and those with a learning disability.
  • 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.