Archived: Dr Robert Gardner Also known as Saltash Road Surgery

Updated 12 November 2015

We carried out an inspection on November 2014 and found the provider was in breach of two regulations relating to recruitment checks

• Regulation 21(b) (effective recruitment procedures).
• Regulation 10(1) (b) (safe systems to manage significant events and assess and manage risks to the health, welfare and safety of patients and show learning had taken place with the whole team).

Both these were within the safe domain. We published a report setting out our judgements and requirement notices; we had asked the provider to send us a report of the changes they would make to comply with the regulations they were not meeting. The provider sent an action plan within agreed timescales. We have followed up this action plan to make sure the necessary changes have been made and found the provider is now meeting the regulations included within the report.

This report should be read in conjunction with the full inspection report. We have not revisited Dr Robert Gardner at Saltash Road Surgery as part of this review because the practice was able to demonstrate compliance without the need for an inspection visit. We have reviewed the information we hold and documents sent to us by the practice.

Updated 12 November 2015

Updated 31 March 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their medicine regimes and that their health and care needs were being met. For those people with the most complex needs, Dr Gardner worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 31 March 2015

The practice is rated as good for the care of families, children and young people. There were well organised baby and child immunisation programmes available to ensure babies and children could access a full range of vaccinations and health screening.

The practice had effective relationships with health visitors, midwives and the local school’s nursing team. They were able to access support from children’s’ workers and parenting support groups. Systems were in place to alert health visitors when children had not attended routine appointments and screening.

The practice referred patients and worked closely with a local family and child service to discuss any vulnerable babies, children or families.

Men, women and young people had access to a full range of contraception services and sexual health screening including chlamydia testing and cervical screening. Patients could also be referred to the specialist sexual health clinic in the city for more complex sexual health screening and treatment.

Appropriate systems were in place to help safeguard children or young people who may be vulnerable or at risk of abuse.

Updated 31 March 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 31 March 2015

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 staff carried out health checks on patients as they attend the practice. This included offering patients referrals to particular groups and clinics for smoking cessation, providing health information, routine health checks and reminders to have medication reviews. The practice also offered age appropriate screening tests including prostate cancer screening and testing cholesterol levels.

Updated 31 March 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case-management of patients experiencing poor mental health, including those with dementia. In particular, advance care planning had been carried out for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Patients had access to a counsellor and were offered on-going support by the counsellor and GPs. Patients who had depression were seen regularly and were followed up if they did not attend appointments.

There was communication, referral and liaison with a psychiatry specialist who offered advice and support. The GPs could refer patients for mental health assessment and also treatment for older patients who had mental health issues. This included advice and assessments for patients with dementia.

GPs and nurses were aware of the Mental Capacity Act 2005 (MCA) and had received training on this. There was nationally recognised examination tools used for people who were displaying signs of dementia.

Updated 31 March 2015

The practice is rated as good for the care of vulnerable people. The practice had a vulnerable patient register. These patients were reviewed monthly at the multidisciplinary team meetings.

Staff told us that there were some patients who had a first language that was not English. Patients with interpretation requirements were known to the practice and staff knew how to access these services.

Patients with learning disabilities were offered and provided a health check every year during which their long term care plans were discussed with the patient and their carer if appropriate.

Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant external agencies if they were concerned about possible abuse, in normal working hours and also out of hours.