Archived: Stoney Stanton Medical Centre

Updated 8 December 2017

The Stoney Stanton Medical Centre is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 4,900 patients living in the Foleshill and surrounding areas of Coventry. A GMS contract is a nationally agreed contract used for medical services providers.

The practice operates from a two storey building which has parking facilities on site with disabled parking spaces. Consultations all take place on the ground floor. There is a disabled access approach to the main reception with a bell system to alert staff to provide assistance to open the main door if required. There is a spacious waiting area allowing easy access for patients with mobility aids to manoeuvre.

The practice population has a higher than average number of patients aged 0 to 14 years and 25 to 40 years and a lower than average number of patients in the 45 to 85 year age group. National data indicates that the area is one that experiences high levels of deprivation. The practice population is mixed with high numbers of patients from ethnic minority groups, whose first language is not English such as Asian and Pakistani.

The practice has two partners (one male and one female) and uses the services of two regular locum GPs. They employ a practice nurse who is also a nurse prescriber, one health care assistant, and a practice manager, who are supported by three reception staff, a prescriptions clerk and a medical secretary.

The practice offer minor surgical procedures such as joint injections, and family planning services including fitting of intrauterine devices and contraceptive implants.

The practice is open at the following times:

• Monday: 8am to 6.30pm
• Tuesday: 8am to 6.30pm – (6.30pm to 7.30pm GP extended hours appointments only)
• Wednesday: 8am to 6.30pm – (6.30pm to 8pm nurse appointments only)
• Thursday: 8am to 6.30pm
• Friday: 8.30am to 6.30pm

The practice does not provide out of hours services beyond these hours. The local out of hours service is provided by the Warwickshire Ambulance Service which can be accessed via the NHS 111 Service. 

Updated 8 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stoney Stanton Medical Practice on 18 October 2017. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events and we saw evidence of this and how learning outcomes had been shared.
• The practice had defined systems to minimise risks to patient safety. Some staff files did not contain all relevant information required prior to commencement of employment as set out in the recruitment policy.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were positive and showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. Patients we spoke with during our inspection confirmed these views.
• The practice had a complaints procedure but this required updating and making clearly visible for patients in the waiting area. However, the practice acted promptly and addressed these issues and confirmed they had made information about how to complain available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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. Results from the national patient survey also supported this view.
• 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.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Ensure all relevant documentation is maintained in staff files in line with the practice recruitment policy.

• Ensure all policies are updated and that review dates are included.
• Minutes of staff meetings should be more comprehensive and circulated to all staff.
• Ensure portable appliance testing (PAT) schedules include all electrical equipment in use at the practice.
• Introduce a means of assuring that the cleaning schedule had been carried out as required.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 December 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice nurse had additional qualifications in long term conditions such as diabetes, asthma and chronic obstructive pulmonary disease (COPD). Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• One GP had a special interest in diabetes and had received additional training in this condition. The overall QOF achievement for diabetes was 90% which was in line with the CCG average of 93% and national average of 91%. Exception reporting was below the CCG and national averages in almost all indicators.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 8 December 2017

The practice is rated as good for the care of families, children and young people.

• There were systems 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 accident and emergency (A&E) attendances.
• Immunisation rates were high for all standard childhood immunisations.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 8 December 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs as well as domiciliary blood tests.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs as well as maintaining regular multi-disciplinary meetings with other care staff involved.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. The practice offered referral to a local representative from Age Concern.

Updated 8 December 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours for both GP and nurse appointments.
• The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice offered a service which allowed patients to order prescriptions and collect from a pharmacy of their choice.

Updated 8 December 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the CCG and national average of 81% and 84% respectively. The practice had not exception reported any patients from this group.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. They offered an in-house service from Dementia UK Admiral Nurses who offered support to patients with dementia and their families.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive care plan documented in the record, in the preceding 12 months, agreed between individuals, their family and/or carers as appropriate which was higher than the CCG and national averages of 88% and 90% respectively.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations. For example, they had Improving Access to Psychological Therapies (IAPT) service attending the practice to offer support to patients.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 8 December 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.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.