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Alderley Edge Medical Practice Good

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 9 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Alderley Edge Medical Practice on 26 September 2017.

Overall the practice is rated as good.

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

  • There were systems in place to reduce risks to patient safety, for example, equipment and premises checks were carried out and there were systems to prevent the spread of infection.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff were aware of procedures for safeguarding patients from the risk of abuse.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.

  • Staff felt supported and they had access to training and development opportunities appropriate to their roles.

  • Patients said they were treated with compassion, dignity and respect. We saw staff treated patients with kindness and respect.

  • Services were planned and delivered to take into account the needs of different patient groups.

  • There was a system in place to manage complaints.

  • There were systems in place to monitor and improve quality and identify risk.

The areas where the provider should make improvements are:

  • Review the system put in place to broaden the scope of issues considered to be a significant event to ensure this is effective.
  • Monitor recruitment records to ensure that all the required information is obtained.
  • Checks of cleaning standards should take place at the branch practice.
  • Review the system put in place to monitor which prescriber the printable prescriptions are distributed to.
  • A central system to monitor staff training should be put in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 9 November 2017

The practice is rated as good for providing safe services. There were appropriate systems in place to ensure that equipment was safe to use.

The practice maintained appropriate standards of cleanliness and hygiene.

Staff were aware of procedures for safeguarding patients from the risk of abuse. Staff knew how to report safety issues and these were investigated and appropriate action taken.

Effective

Good

Updated 9 November 2017

The practice is rated as good for providing effective services. Patients’ needs were assessed and care was planned and delivered in line with current legislation. Staff referred to best practice guidance such as the National Institute for Health and Care Excellence (NICE) and used it routinely. Staff worked with other health care teams and there were systems in place to ensure appropriate information was shared. Staff had

access to training and development opportunities appropriate to their roles.

Caring

Good

Updated 9 November 2017

The practice is rated as good for providing caring services. Patients spoken with and who returned comment cards were positive about the care they received from the practice. We observed throughout the inspection that members of staff were courteous and helpful to patients both attending at the reception desk and on the telephone.

Responsive

Good

Updated 9 November 2017

The practice is rated as good for providing responsive services. Services were planned and delivered to take into account the needs of different patient groups. A range of access to the service was provided.

The practice had a complaints policy which provided staff with guidance about how to handle a complaint.

Well-led

Good

Updated 9 November 2017

The practice is rated as good for providing well-led services. There was a clear leadership structure, staff were clear about their roles and responsibilities and felt supported by management. The practice had a number of policies and procedures to govern activity and held governance and staff meetings. The practice proactively sought feedback from staff and patients, which it acted on.

Checks on specific services

Older people

Good

Updated 9 November 2017

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

T he practice kept registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu and shingles. All patients over 75 had a named GP. GPs visited three local nursing homes weekly. V

isits were carried out by the same clinicians to provide continuity and these clinicians were available for senior care home staff to contact for advice outside of these visits. The

practice worked with other agencies and health providers to provide support and access specialist help when needed.

Care plans were in place for patients with a high risk of being admitted to hospital. A care co-ordinator followed up all hospital discharges to assess what support

was needed to

minimise re-admission to hospital. The practice nurse provided home visits for chronic disease management. Housebound patients could order repeat medication by telephone and a medication delivery service was provided through the patients chosen pharmacy. The practice had a list of patient volunteers who were willing to transport older patients to the practice for appointments.

People with long term conditions

Good

Updated 9 November 2017

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure patients received regular reviews for long term conditions. The practice used the information collected for the Quality and Outcomes Framework (QOF) and performance against national screening programmes to monitor outcomes for patients. QOF is a system intended to improve the quality of general practice and reward good practice. Current unpublished results (2016/2017) showed the practice was performing well in relation to these targets. The clinical team took the lead for different long term conditions. Specialist practice nurses reviewed patients with asthma, chronic obstructive pulmonary disease (COPD) and diabetes. Care plans were in place for patients with COPD. Practice nurses were available during extended hours to facilitate ease of access for patients requiring a review of their long term condition. The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access to specialist help when needed.

Families, children and young people

Good

Updated 9 November 2017

The practice is rated as good for the care of families, children and young people. Post-natal checks were undertaken by GPs. Child health surveillance and immunisation clinics were provided. Pre-conception guidance was provided to patients wishing to become pregnant. Priority was given to young children who needed to see the GP and appointments were available outside of school hours. The staff we spoke with had appropriate knowledge about child protection and how to report any concerns. Child health promotion information was available on the practice website and in leaflets displayed in the waiting area. Family planning and sexual health services were provided. Young peoples’ views about the operation of the practice were voiced through representatives on the Patient Participation Group (PPG).

Working age people (including those recently retired and students)

Good

Updated 9 November 2017

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice appointment system and opening times provided flexibility to working patients and those in full time education. The main practice was open from 8am to 6.30pm Monday to Friday and on Saturday mornings for pre-bookable appointments from 8.30am to 10.30am. The branch practice was open Monday to Friday 8am to 12.30pm. Urgent and routine appointments were available. Patients could book appointments in person, via the telephone and on-line. Repeat prescriptions could be ordered on-line and by attending the practice. Summary patient records were available on-line. Telephone consultations were also provided. The practice website provided information around self-care and local services available for patients. The practice offered health promotion and screening that reflected the needs of this population group such as cervical screening, contraceptive services, smoking cessation advice, NHS health checks and family planning services. Reception staff sign-posted patients who did not necessarily need to see a GP, for example patients were advised about physiotherapy services. A phlebotomy service was also provided at the practice which meant that patients did not have to travel to receive this service.

People whose circumstances may make them vulnerable

Good

Updated 9 November 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable. A register was kept of patients with a learning disability, there was a lead GP for these patients, a flexible appointment system to meet their needs and a system to ensure these patients received an annual health check. The staff we spoke with had appropriate knowledge about safeguarding vulnerable adults and children. Services for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. A member of staff acted as a carer’s link and they were working to identify carers and promote the support available to them. The practice referred patients to local health and social care services for support, such as drug and alcohol services and to the well-being service. The practice had multi-disciplinary meetings where the needs of vulnerable patients were discussed. The practice worked with other agencies and health providers to provide support and access to specialist help when needed.

People experiencing poor mental health (including people with dementia)

Good

Updated 9 November 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients experiencing poor mental health, including dementia, an annual health check and a medication review. Care plans were in place to support patients. Same day urgent triage was carried out when patients reported a decline in their mental health. Opportunistic dementia screening was undertaken for at risk patients. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice referred patients to appropriate services such as memory clinics, psychiatry and counselling services. Patients were also signposted to relevant services such as Age UK, and the Alzheimer’s Society and were offered resources such as talking therapies and on-line self-help resources. The staff team had received training in dementia awareness to assist them in identifying patients who may need extra support.