Archived: Crosland Moor Surgery

Updated 22 November 2016

Crosland Moor Surgery, 11 Park Rd West, Crosland Moor, Huddersfield, HD4 5RX provides services for 4200 patients. The surgery is situated within the Greater Huddersfield Clinical Commissioning Group and provides primary medical services under the terms of a personal medical services (PMS) contract. The area is more deprived than average and the population is mainly White British. There are a small number of Black African-Caribbean or South Asian ethnicity patients and the practice is currently supporting several refugee families from the Syrian conflict.

Crosland Moor surgery is registered as a partnership between Dr Chandrakala Sodagam Rao and Dr Michael Taylor.However, Dr Taylor has taken retirement and we have advised the practice that they must make the necessary application to correct their registration with us without delay and following the inspection, an application has been received.

Services are provided within a purpose built and accessible building. The premises are currently leased from NHS Property Services. There are two full time GPs (male and female). An advanced nurse practitioner works 2 days a week and a practice nurse is available for 23 hours a week. The practice has two health care assistants who work the equivalent of one full time health care assistant and five part time reception staff. The practice employs a cleaner who attends daily.

The practice is open Monday to Friday from 8.30am to 6pm. The practice closes for lunch each day between 12.30-1.30pm however urgent calls can be made to practice staff during this time. Out of hours treatment is provided by Local Care Direct.

Updated 22 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crosland Moor Surgery on 29 June 2016. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. However, learning from incidents was shared informally and not embedded into updated policies and procedures.
• Risks to patients were mostly assessed and well managed. However, not all recruitment checks were consistently completed and the provider had not undertaken a recent fire drill.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available on request and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

The provider must make improvements in order to operative effective governance systems. This includes improving records of meetings within the practice and embedding learning from significant events into revised polcies and procedures. They must also develop, and operate effectively, systems to monitor staff training, the scheduling and completion of fire drills, records of cleaning and be able to demonstrate quality improvement activity, including clinical audits.

In addition the provider should:

• Review the current fire safety procedures.
• Review their recruitment arrangements to assure themselves that all necessary employment checks are completed for all staff prior to them commencing employment with the practice.
• Review the provision of information about the complaints procedure in reception.
• Review working arrangements across the clinical team to facilitate the provision of practice protected time and attendance at internal governance meetings is enabled for all relevant staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 22 November 2016

The practice is rated as requires improvement for the care of people with long-term conditions. The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• 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 their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 November 2016

The practice is rated as requires improvement for the care of families, children and young people. The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• 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 with rates between 96-100%.

• 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.

• Uptake for the cervical screening programme was 92%, which was higher than the CCG average of 85% and the national average of 82%. However, the clinical exception rate for screening was 20%, which was higher than the local and national average of 6%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 22 November 2016

The practice is rated as requires improvement for the care of older people. The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• 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 identified older patients on multiple medications and reviewed their needs with the community pharmacy team.

• The practice worked closely with the Community Matron and hospital discharge coordinator to support older patients.

Updated 22 November 2016

The practice is rated as requires improvement for the care of working age people (including those recently retired and students). The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group including smoking cessation and weight management support.

• Health checks were offered to new registrations and those aged over 40.

• The age profile of patients at the practice is mainly those of working age, students and the recently retired but accessibility to services did not fully reflect the needs of this group. A limited number of appointments were available to be booked on line. Telephone lines to the practice were closed to patients between 12.30-1.30pm Monday to Friday unless the patient had an urgent query.

• The practice did not currently offer any extended hours for early or late appointments. However, we saw that the practice would offer appointments at either end of the working day to accommodate patients that could not attend during the day. Patients could not order repeat prescriptions online.

Updated 22 November 2016

The practice is rated as requires improvement for the care of people experiencing poor mental health (including people with dementia). The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• 95% of patients with a serious mental illness had their care reviewed in the previous 12 months, which was higher than the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice 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.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia. This included phoning and/or texting patients to remind them of upcoming appointments.

Updated 22 November 2016

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable. The provider was rated as requires improvement for providing safe and well led services. The issues identified as requires improvement overall affected all patients including this population group.

• The practice held a register of patients living in vulnerable circumstances including people experiencing homelessness or temporary living arrangements and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.