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Archived: Eccleston Medical Centre Partnership Good

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Inspection Summary


Overall summary & rating

Good

Updated 8 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eccleston Medical Centre Partnership on 19 September 2017. Overall the practice is rated as good. Our key findings across all the areas we inspected were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Significant events had been investigated and action had been taken as a result of the learning from events.

  • Systems were in place to deal with medical emergencies and staff were trained in basic life support.

  • There were systems in place to reduce risks to patient safety. For example, infection control practices were carried out appropriately and there were regular checks on the environment and on equipment used.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

  • Feedback from patients about the care and treatment they received from clinicians was highly positive. Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.

  • Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.

  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • Patients said they could get an urgent appointment when needed but some felt they had to wait too long for a routine appointment.

  • Complaints had been investigated and responded to in a timely manner.

  • There was a clear leadership and staff structure and staff understood their roles and responsibilities.

  • The practice had a clear vision to provide a safe and high quality service.

  • The practice provided a range of enhanced services to meet the needs of the local population.

  • The practice sought patient views about improvements that could be made to the service. This included the practice having and consulting with a patient participation group (PPG).

Areas where the provider should make improvement:

  • Review the management of the appointments system to facilitate greater flexibility for booking routine appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 8 November 2017

The practice is rated as good for providing safe services.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff learnt from significant events and this learning was shared across the practice.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguard them from abuse.

  • Staff had been trained in safeguarding and they were clearly aware of their responsibilities to report safeguarding concerns. Information to support them to do this was widely available throughout the practice.

  • Procedures were in place to ensure appropriate standards of hygiene were maintained to prevent the spread of infection.

  • Health and safety related checks were carried out on the premises and on equipment on a regular basis.

  • Pre-employment checks had been carried out to ensure staff suitability.

  • Systems were in place to ensure the safe prescribing of medicines. Patients had a regular review of their medicines as appropriate and people who required regular monitoring for their medicines received this.

  • The practice was equipped with a supply of medicines to support people in a medical emergency.

Effective

Good

Updated 8 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 best practice guidance.

  • The practice monitored its performance data and had systems in place to improve outcomes for patients. Data showed that outcomes for patients at this practice were comparable to those locally and nationally.

  • Staff worked alongside other health and social care professionals to understand and meet the range and complexity of patients’ needs.

  • Clinicians met on a regular basis to review the needs of patients and the clinical care and treatment provided.

  • Clinical audits were carried out to drive improvement in outcomes for patients.

  • Staff felt well supported and they had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • A system of appraisals was in place and all staff had undergone an up to date appraisal of their work.

Caring

Good

Updated 8 November 2017

The practice is rated as good for providing caring services.

  • Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment. They gave us very positive feedback about the caring nature of staff.

  • We saw that staff treated patients with kindness and respect, and maintained confidentiality.

  • Data from the national patient survey showed that the practice received scores that were higher than local and national average for aspects of care. For example, having tests and treatments explained and for being treated with care and concern.

  • Information for patients about the services available to them was easy to understand and accessible.

  • The practice maintained a register of patients who were carers in order to tailor the services provided. For example to offer them health checks and immunisations.

  • A notice board had been designated to provide information for carers.

Responsive

Good

Updated 8 November 2017

The practice is rated as good for providing responsive services.

  • The practice reviewed the needs of the local population and worked in collaboration with the NHS England Area Team, Clinical Commissioning Group (CCG) and partner agencies to secure improvements to services where these were identified and to improve outcomes for patients.

  • Patients we spoke with said they could get an urgent appointment when needed. But a number of patients said they felt they waited too long for a routine appointment.

  • The practice was equipped to treat patients and meet their needs.

  • Information about how to complain was available and the practice responded quickly to issues raised. Any learning from complaints was shared appropriately.

Well-led

Good

Updated 8 November 2017

The practice is rated as good for being well-led.

  • The practice had a vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about their responsibilities in relation to this.

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

  • There were good systems in place to govern the practice and support the provision of good quality care.

  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.

  • The practice used feedback from staff and patients to make improvements. This included the practice having an active patient participation group (PPG).

  • There was a focus on continuous learning, development and improvement linked to outcomes for patients.

  • The challenges and future developments of the practice had been considered.

Checks on specific services

People with long term conditions

Good

Updated 8 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. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

  • The clinical team provided regular, structured reviews of patients’ health.

  • Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery.

  • Performance data showed that the practice was performing similarly to other practices nationally for the care and treatment of people with chronic health conditions.

  • The practice held regular multi-disciplinary meetings to discuss patients with complex needs and patients receiving end of life care.

  • Patients were provided with advice and guidance about prevention and management of their health and were signposted to support services.

Families, children and young people

Good

Updated 8 November 2017

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

  • There were systems in place to identify and follow up children living in disadvantaged circumstances and those who were at risk, for example, children and young people who had a high number of A&E attendances.

  • One of the GPs was the designated lead for safeguarding.

  • Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

  • Immunisation rates were comparable to the national average for all standard childhood immunisations. Opportunistic immunisations were given to encourage uptake. The practice monitored non-attendance of babies and children at vaccination clinics and staff told us they would report any concerns they identified to relevant professionals.

  • Babies and young children were offered an appointment as a priority and appointments were available outside of school hours.

  • The premises were suitable for children and babies and baby changing facilities were available.

Older people

Good

Updated 8 November 2017

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

  • The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population.

  • The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

  • Nationally reported data showed that outcomes for patients for conditions commonly found in older people were comparable to outcomes for patients locally and nationally.

  • GPs carried out regular visits to a local care home to assess and review patients’ needs and to prevent unplanned hospital admissions.

  • Home visits and urgent appointments were provided for patients with enhanced needs.

  • The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care.

Working age people (including those recently retired and students)

Good

Updated 8 November 2017

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

  • The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

  • Telephone consultations were provided and patients therefore did not always have to attend the practice in person.

  • The practice provided a full range of health promotion and screening that reflected the needs of this age group.

  • The practice was proactive in offering online services including the booking of appointments and requests for repeat prescriptions. Electronic prescribing was also provided.

People experiencing poor mental health (including people with dementia)

Good

Updated 8 November 2017

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

  • The practice held a register of patients experiencing poor mental health and these patients were offered an annual review of their physical and mental health.

  • Data about how people with mental health needs were supported showed that outcomes for patients using this practice were comparable to local and national averages.

  • A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health.

  • Systems were in place to prompt patients for medicines reviews at intervals suitable to the medication they were prescribed.

  • The practice referred patients to appropriate services such as psychiatry and counselling services and patients were informed about how to access various support groups and voluntary organisations.

People whose circumstances may make them vulnerable

Good

Updated 8 November 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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

  • The practice worked with other health and social care professionals in the case management of vulnerable people.

  • A list of vulnerable patients was maintained to ensure these patients were given access to an appointment on the day.

  • 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.

  • The practice provided access and facilities for people who were disabled.

  • Information and advice was available about how patients could access a range of support groups and voluntary organisations.