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Inspection Summary


Overall summary & rating

Good

Updated 4 September 2020

We carried out an announced comprehensive inspection at Newland Health Centre on 30 May 2017. The overall rating for the practice was good, but was rated as requires improvement for the safe key question. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for Newland Health Centre on our website at .

This inspection was a desk-based review carried out on 02 July 2020 to confirm that the practice was improving:

  • Reviews of incidents and near misses.
  • Their recruitment arrangements.
  • Patient outcomes as a result of clinical audits.
  • Their learning from significant events.
  • Their system for monitoring and acting on uncollected prescriptions.
  • Their fire alarm testing procedures.

This report covers our findings in relation to those requirements.

The practice remains rated as Good overall and has improved its rating of Requires improvement for the safe key question to Good.

Our key findings were as follows:

  • The practice had improved their process, monitoring and review of incidents and near misses.
  • The practice had improved their recruitment arrangements.
  • The practice had implemented an annual audit plan which identified patient outcomes.
  • The practice had improved their process, monitoring and review of significant events.
  • The practice had improved their process for the monitoring of uncollected prescriptions.
  • The practice had improved their process for fire alarm management and testing.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Inspection areas

Safe

Good

Effective

Good

Caring

Good

Responsive

Good

Well-led

Good
Checks on specific services

People with long term conditions

Good

Updated 29 June 2017

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

  • The practice had a much smaller proportion of patients with long term conditions in its practice population compared to local and national averages. Patients who had a long term condition, for example asthma, tended to miss appointments for reviews as they were only resident during term time, which led to exception reporting figures appearing high.

  • Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

  • The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was 95% which was above the local figure of 79% and the national figure of 78%; however the exception reporting figures were 15.2% above national figures. The clinical prevalence of patients at the practice with diabetes was much lower than local and national averages.

  • The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 83% which was slightly above the local figure of 80% and the national figure of 80%, however exception reporting figures were 17.4% above the national figure.

  • 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.

Families, children and young people

Good

Updated 29 June 2017

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

  • From the sample of documented examples we reviewed we found 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 relatively 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, health visitors and school nurses 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.

Older people

Good

Updated 29 June 2017

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

  • The practice had a much smaller proportion of older patients in its practice population compared to local and national averages.

  • 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.

  • 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.

Working age people (including those recently retired and students)

Good

Updated 29 June 2017

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

  • The practice had a much higher proportion of patients who were students due to its situation opposite the University. This included a high proportion of overseas students and led to peaks of registration and practice patient list size at term times.

  • 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, social prescribing (signposting to citizens advice bureau and charities to help with debt issues and benefits) and a drug and alcohol support service.

  • 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.

  • The practice hosted a sexual health service and tuberculosis screening.

People experiencing poor mental health (including people with dementia)

Good

Updated 29 June 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.

  • The practice specifically considered the physical health needs of patients with poor mental health and dementia.

  • The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs, however on the day we found some prescriptions had not been collected.

  • The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record was 73% which was below the national average of 89%.

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

  • Patients at risk of dementia were identified and offered an assessment.

  • The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

  • They hosted an in-house mental health service twice weekly.

  • 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.

People whose circumstances may make them vulnerable

Good

Updated 29 June 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.