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Adlington Medical Centre Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 17 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the practice of Adlington Medical Centre on 6 December 2016. 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed, including those relating to recruitment checks.

  • 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.

  • Data showed patient outcomes were comparable to those locally and nationally.
  • Feedback from patients about their care was strongly positive,

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.

  • Information about services and how to complain was available and easy to understand.

  • Patient’s views were positive when asked how easy it was to make an appointment including availability of same day appointments.

  • 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. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 January 2017

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events. Lessons were shared to make sure action was taken to improve safety in the practice.
  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.
  • The practice had systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 17 January 2017

The practice is rated as good for providing effective services.

  • Data showed patient outcomes were comparable to the locality.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of patient’s needs.

Caring

Good

Updated 17 January 2017

The practice is rated as good for providing caring services.

  • We observed a strong patient-centred culture
  • Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this.
  • Data showed that patients rated the practice in line with or above others 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 services available was easy to understand and accessible.
  • We also saw that staff treated patients with kindness and respect and maintained confidentiality.

Responsive

Good

Updated 17 January 2017

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 patient’s needs.
  • Patients could access appointments and services in a way and at a time that suited them.
  • Telephone consultations were readily available and home visits, including the phlebotomy service provided to house bound patients.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.
  • The practice was well equipped to treat patients and meet their needs and a planned move to new premises was imminent and would improve facilities and increase space with the practice.
  • Information about how to complain was available and easy to understand. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 17 January 2017

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

  • There was a strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the practice vision and their responsibilities in relation to this.
  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the Duty of Candour. The partners encouraged a culture of openness and honesty. The practice had systems in place for knowing about notifiable safety incidents
  • The practice proactively sought feedback from staff and patients, which it acted on.
Checks on specific services

People with long term conditions

Good

Updated 17 January 2017

The practice is rated as good 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.
  • Where appropriate, patients with more than one long-term condition were able to access a joint review to prevent them having to make multiple appointments.
  • All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For patients with complex needs, a named GP and practice nurse worked with relevant community and healthcare professionals to deliver multidisciplinary support and care. Multidisciplinary meetings were held to review patients’ needs and to avoid hospital admissions.
  • Patients with COPD and asthma had self-management plans and those with chronic conditions were provided with care plans.
  • Patients who were diagnosed with a long term conditions such as diabetes were directed to a structured education programme.

Families, children and young people

Good

Updated 17 January 2017

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 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.

Older people

Good

Updated 17 January 2017

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

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

Working age people (including those recently retired and students)

Good

Updated 17 January 2017

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.

  • Appointments with a GP at Adlington Medical Centre were available Monday to Friday 8:15am to 10:35am and 3:15pm to 5:25pm. In addition patients could access appointments on a Saturday at another practice within the group at Buckshaw Village Health centre. Patients could also attend daily walk in surgeries at Buckshaw Village Health centre if they were unable to book a convenient appointment at Adlington.
  • 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 17 January 2017

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

  • 100% (10% exception reporting 3% above the CCG average) of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months.
  • 100% (9% exception reporting 12% below the CCG average) of patients with poor mental health had a comprehensive care plan documented in the record agreed between individuals, their family and/or carers as appropriate.
  • 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 had told patients experiencing poor mental health how to access various support groups and voluntary organisations.
  • Staff had a good understanding of how to support people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 17 January 2017

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.
  • The practice was aware of those patients who required an interpreter and used a translation telephone service where required.

  • Vulnerable patients were identifiable with alerts noted on the secure computer system to ensure staff were alerted to needs. There was a clear policy and procedure in place to support homeless patients.
  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
  • The practice had told vulnerable patients 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.