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Inspection Summary


Overall summary & rating

Good

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at York House Medical Centre on 11 November 2015. Overall the practice is rated as good.

Our key findings 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. Quality and risk reports were compiled monthly by the practice manager to identify and remedy any issues.

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs were leads in different areas and had regular clinical leads meetings to discuss concerns and disseminate learning.

  • One of the challenges faced by the practice was the age of the building. The practice had put in a bid for a new building under the primary care infrastructure fund. This was in early stages at the time of the inspection.

  • There was a clear leadership structure and staff felt supported by management.

  • Risks to patients were assessed and well managed.

  • Patients described staff as professional, efficient and helpful.

  • The practice had a Carer Support Adviser offering support to patients who were carers. Patients could book an appointment with them via the administration team.Appointments were offered at the surgery and at home.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 18 February 2016

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were enough staff to keep patients safe.

Effective

Good

Updated 18 February 2016

The practice is rated good for providing effective services. National patient data showed that the practice was at or above the average for the locality on the whole. For example the performance for diabetes-related indicators was 97.7% which was above the CCG average of 94.4% and above the national average of 89.2%. Staff referred to guidance from the National Institute for Health and Care Excellence (NICE) and used it routinely. Staff had received training appropriate to their roles and the practice believed in developing and training their staff. Staff routinely worked with multidisciplinary teams.

Caring

Good

Updated 18 February 2016

The practice is rated good for providing caring services. Patients felt involved in their care and treatment and described staff as helpful, professional and kind. Patient information was easy to understand and accessible to patients. We saw staff treated patients with dignity and respect. In the patient survey published in July 2015 it showed that 90.3% said the last GP they spoke to was good at treating them with care and concern compared to the CCG average of 88.1% and national average of 85.1%.

Responsive

Good

Updated 18 February 2016

The practice is rated good for providing responsive services. The practice responded to the needs of its local population and engaged well with Wyre Forest Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services. The practice was well equipped to meet the needs of their patients. Information about how to complain was available and easy to understand. Learning from complaints was shared and discussed at practice meetings. The practice worked closely with community well-being buddies. This was a service which signposted patients to the voluntary sector and social services to reduce social isolation and to implement lifestyle changes.

Well-led

Good

Updated 18 February 2016

The practice is rated good for being well-led. It had a clear vision and strategy. The practice was looking at ways to continuously improve and they had a programme of continuous clinical and internal audit. Staff told us there was an open culture and they were happy to raise issues at practice meetings. The partners were visible in the practice and staff told us they would take the time to listen to them. Staff we spoke with said there was a no blame culture which made it easier for them to raise issues. We saw that there was good morale at the practice.

The practice proactively sought feedback from staff and patients, which it acted on and had an active Patient Participation Group (PPG). A PPG is a group of patients registered with a practice who work with the practice to improve services and the quality of care.

Checks on specific services

People with long term conditions

Good

Updated 18 February 2016

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. Patients with long term conditions had annual reviews.

The practice worked closely with multidisciplinary teams to help patients with long-term conditions.

The clinical leads at the practice met regularly to discuss diabetes, respiratory care, admissions avoidance and anti-coagulation (patients who were on blood thinning medicine).

The practice offered a shared-care drug monitoring service for the medicines used for patients with rheumatoid arthritis (a disease causing inflammation of the joints). This offered patients a convenient service whilst the need for continuation of the medicines was reviewed via the recall system.

The practice offered a stop smoking service.

Families, children and young people

Good

Updated 18 February 2016

The practice is rated as good for the care of families, children and young people. There were systems in place to follow up on children the practice was concerned about for example children who did not attend appointments. The administration team worked proactively to contact families of children who had not been immunised. There were regular multi-disciplinary meetings at the practice where safeguarding concerns were discussed. The meetings included the lead GP for safeguarding, specialist midwives, health visitor and school nurses.

Older people

Good

Updated 18 February 2016

The practice offered personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, unplanned admissions and dementia. The practice had a register of patients who had had unplanned hospital admissions and had care plans for each of these patients. The practice had a monthly meeting to discuss unplanned admissions.

The practice was responsive to the needs of older people. For example, the practice offered an enhanced level of care to patients who live in three care homes. Each home had a named GP and patients were visited within 10 days of admission. Each of the residents had a care plan and ward rounds were done every four weeks and more frequently if required. The practice worked closely with the community matron who did weekly ward rounds at the residential homes.

The practice supported the community staff with the virtual ward. These patients had direct access to the community matron. The lead GP met with the community matron on a regular basis and fed back any concerns to the rest of the team at practice meetings.

The lead GP held a Diploma in Palliative Care and worked one day a week at a hospice. Patients’ care preferences were communicated at the multi-disciplinary team meetings and out of hours when required.

 A pharmacist was present at the practice to offer advice to patients for example after discharge from hospital and after outpatient appointments. The pharmacist was available to respond to medication queries. 

Working age people (including those recently retired and students)

Good

Updated 18 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice worked closely with the fit for work programme; this enabled GPs to refer patients for an occupational health assessment.

The practice offered on-line repeat prescriptions which benefitted those patients with time restrictions.

Appointments were available from 7am to 6pm every day. This included both face to face appointments and telephone appointments. Phlebotomy (blood taking service) was offered at the surgery which avoided the need for patients to go to the local hospital.

People experiencing poor mental health (including people with dementia)

Good

Updated 18 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All staff at the practice had received dementia awareness training. There was a community psychiatric nurse attached to the practice. The practice could refer patients to them and they would refer on as required.

People whose circumstances may make them vulnerable

Good

Updated 18 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice worked closely with community well- being buddies. This was a service which signposted patients to the voluntary sector and social services to reduce social isolation and to implement lifestyle changes.

A community drugs and alcohol worker attended the practice once a week and did a shared clinic with the GPs fortnightly.

The practice had a carer support advisor offering support to patients who were carers. Patients could book an appointment with them via the administration team. Appointments were offered at the surgery and at home.