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Dr Keith T Tattum Good Also known as Dr KT Tattum

Inspection Summary


Overall summary & rating

Good

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Keith Tattum on 14 December 2015. Overall the practice is rated as good.

Our key findings were as follows:

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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 and easy to understand.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Feedback about the appointment system was mixed; patients told us they could get an urgent appointment when needed, although some said it was difficult to book a future appointment.

We saw a feature of outstanding practice:

  • The lead GP had an interest in poor mental health. The practice used nationally recognised assessment methods in determining the levels of depression experienced by patients and also offered relevant patients a psychological assessment. Patients experiencing depression had the opportunity to enter a contract with the practice to detail their expectations and hopes for the management of their condition. Data demonstrated that the practice was effective in their management and identification of patients with depression.

There were areas where the practice should make improvements:

  • Implement changes in infection control within the practice as detailed in the infection control specialist’s audit.

  • Undertake a written risk assessment for Legionella and mitigate any risks identified.

  • Consider obtaining wider feedback from patients about the practice appointment system and improve the availability of bookable future appointments with GPs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 February 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology. They were told about any actions to improve processes to prevent the same thing happening again.

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

  • We saw the practice needed to improve their management of infection control risks, although action was taken the day after our inspection.

Effective

Good

Updated 11 February 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were at or above average for the locality and compared to the national average.

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

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 11 February 2016

The practice is rated as good for providing caring services.

  • Feedback from patients about their care and treatment was consistently and strongly positive.

  • We observed a strong patient-centred culture.

  • Data from the National GP Patient Survey showed patients rated the practice higher than others for several aspects of care.

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

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

Responsive

Good

Updated 11 February 2016

The practice is rated as good for providing responsive services.

  • Same day appointments were available for children and those with serious medical conditions.

  • Data from 2014/15 showed that the number of patients who attended Accident and Emergency departments was 36.8% lower than the national average.

  • Patient feedback was positive about the availability of urgent appointments, although some patients told us it could be difficult to book a future appointment.

  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 11 February 2016

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

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

  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.

  • 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 had systems in place for knowing about notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken.

Checks on specific services

People with long term conditions

Good

Updated 11 February 2016

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

  • Patients at the highest risk of unplanned admission to hospital were identified and care plans had been implemented to meet their health and care needs.

  • Performance for the diabetes related indicators was comparable with the CCG and national averages. For example, 77.4% of patients with diabetes had received a recent blood test to indicate their longer term diabetic control was below the highest accepted level, compared with the CCG average of 75.1% and national average of 77.5%.

  • Longer appointments and home visits were available when needed.

Families, children and young people

Good

Updated 11 February 2016

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

  • We received positive feedback from patients in this group.

  • Children under 12 were offered a same day appointment.

  • The practice provided childhood immunisations and uptake rates were comparable to CCG and national averages.

  • The practice’s uptake for the cervical screening programme was 85.2% which was higher than the CCG average of 79.9% and the national average of 81.8%. The practice performance in this area was the highest within the CCG area.

Older people

Good

Updated 11 February 2016

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

  • 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.

  • Seasonal Flu vaccination rates for the over 65s were 76.6% compared with the national average of 73.2%.

Working age people (including those recently retired and students)

Good

Updated 11 February 2016

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.

  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

  • The practice offered evening appointments to benefit those of a working age.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 February 2016

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

  • 100% of patients with severe poor mental health had a comprehensive care plan completed within the previous 12 months, compared with the CCG average of 86.3% and national average of 88.3%.

  • The practice used nationally recognised assessment methods in determining the levels of depression experienced by patients and also offered relevant patients a psychological assessment.

  • 8.67% of patients had been identified as experiencing depression. This was higher than the CCG average of 7.74% and national average of 5.82%.

  • Patients experiencing depression had the opportunity to enter a contract with the practice to detail their expectations and hopes for the management of their condition.

  • 96.6% of patients with dementia had a face to face review of their condition in the last 12 months. This was higher than the CCG average of 85.1% and national average of 84%.

People whose circumstances may make them vulnerable

Good

Updated 11 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulner

able.

  • The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

  • The practice offered annual health reviews and longer appointments for patients with a learning disability.

  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations.