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Anchor Medical Practice Good Also known as Netherton Health Centre

Inspection Summary


Overall summary & rating

Good

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We completed a comprehensive inspection at Dr Perera, Harvey and Sandhu Medical Practice on 13 January 2015. We found the practice to be good in the five key areas that we looked at and gave the practice an overall rating of good.

Our key findings were as follows:

  • Systems were in place to ensure that all staff had access to relevant national patient safety alerts. Staff signed to confirm that they had read these documents and they were discussed at clinical staff meetings.

  • Infection prevention and control systems were well managed and staff had received appropriate training. Lead roles had been assigned to manage infection control and staff were aware of who held the lead role.

  • Staff were friendly, caring and respected patient confidentiality. Patients we spoke with said that all staff were compassionate, listened to what they had to say and treated them with respect. We observed that staff at the reception desk maintained confidentiality and appeared to have a good relationship with patients using the service.

  • The practice had a clear vision to deliver high quality care and promote good outcomes for patients. This was evident when speaking with staff and patients during our inspection. There was a clear leadership structure with named staff in lead roles. Staff were aware who they should speak with if they needed guidance or advice. Staff reported that they worked well as a team and could approach the practice manager or GPs if they needed to discuss anything.

However, there were areas of practice where the provider should make improvements.

  • Develop the Incident/significant event reporting, recording and monitoring process to ensure trends and lessons learnt are captured and shared internally, and where appropriate externally.
  • Review process for recording details of children with a protection plan to ensure records remain updated.
  • Develop robust medicine management systems to include records to demonstrate that medication to be used in an emergency is available and within its expiry date, systems to demonstrate that stock checks and stock rotation of vaccinations received at the practice take place and to develop systems for the management and monitoring of prescription pads.
  • Ensure that records are available to demonstrate that equipment to be used in an emergency situation is regularly checked and maintained.
  • Ensure that recruitment processes are followed so that information required under current legislation is obtained prior to employment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 June 2015

The practice is rated as good for providing a safe service. Staff had received training regarding the safeguarding of vulnerable adults and children and clinical staff had undertaken Mental Capacity Act training. Practice nurses had undertaken infection control audits and action had been taken to address some issues identified. Infection prevention and control training had been undertaken. Staff understood their responsibilities to raise concerns, and report incidents and near misses. However, when things went wrong, reviews and investigations were not sufficiently thorough and lessons learnt were not communicated widely enough to support improvement. Robust recruitment checks had not been undertaken on the member of staff most recently employed. There was no documentary evidence to demonstrate that emergency equipment and medication was checked regularly to ensure that it was available and safe for use.

Effective

Good

Updated 11 June 2015

The practice is rated as good for providing effective services. NICE guidance was referenced and used routinely. Effective arrangements were in place to identify, review and monitor patients with long term conditions and those in high risk groups. Patients had access to a range of support to maintain a healthy lifestyle and improve their health. The majority of staff have received core and mandatory training appropriate to their roles and further training needs had been identified and planned. There was evidence of staff appraisals to support their roles and personal development plans were in place for staff. Multidisciplinary working was evidenced.

Caring

Good

Updated 11 June 2015

The practice is rated as good for providing caring services. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. There were arrangements in place to provide patients with end of life care that was compassionate and respected patients’ needs and wishes. Accessible information was provided to help patients understand the care available to them. We also saw that staff treated patients with kindness and respect ensuring confidentiality was maintained.

Responsive

Good

Updated 11 June 2015

The practice is rated as good for providing responsive services. The practice reviewed the needs of their local population and engaged with the Clinical Commissioning Group (CCG) to secure service improvements where these were identified. Patients reported recent improvement regarding access to the practice and a named GP and continuity of care, with urgent appointments available the same day. The practice had an active patient participation group (PPG) which worked with together with practice staff to make changes to improve services and gather patient opinion regarding the service offered. The PPG is a way in which patients and GP practices can work together to improve the quality of the service. The practice had good facilities and was well equipped to treat patients and meet their needs.

Well-led

Good

Updated 11 June 2015

The practice is rated as good for being well-led. The practice had a clear vision. 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. The practice proactively sought feedback from staff and patients and this had been acted upon. The practice had an active patient participation group (PPG). Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

People with long term conditions

Good

Updated 11 June 2015

The practice is rated as good for the population group of people with long term conditions. Specialist clinics, screening and advice was offered to patients with long term conditions. For those people with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. All patients on the long-term condition registers received healthcare reviews and person-centered care plans had been developed. When needed longer appointments and home visits were available. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions. The practice nurses had received the training they needed to provide good outcomes for patients with long-term conditions. Patients who were on long term medication as a result of their condition received regular reviews to assess their progress and ensure their medications remained relevant to their health needs.

Families, children and young people

Good

Updated 11 June 2015

The practice is rated as good for the population group of families, children and young people. Safeguarding procedures were in place for identifying and responding to concerns about children who were at risk of harm. Staff had undertaken training on child protection and were aware of their roles and responsibilities in relation to this. Systems were in place for identifying and following-up children who were at risk. For example, there was an alert system on the patients’ electronic record although some of these records were not up to date.

Immunisation rates were high for all standard childhood immunisations. The practice was proactive in monitoring and recalling children for scheduled immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with health visitors. Women were given advice and information about cervical screening programs.

Older people

Good

Updated 11 June 2015

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. All patients over 75 years of age had an allocated named GP. This is an accountable GP to ensure these patients received co-ordinated care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. The wishes of people requiring end of life care were met, this included care being provided in the patient’s home by the GP and multi-disciplinary team. Telephone consultations were available so patients could call and speak with a GP if they did not wish to or were unable to attend the practice.

Working age people (including those recently retired and students)

Good

Updated 11 June 2015

The practice is rated as good for the population group of working age people (including those recently retired and students). The practice patient age profile is mainly those of working age, students and the recently retired. Recent changes introduced such as on-line booking, repeat prescription ordering and the addition of extra appointments to help staff manage capacity had helped to ensure that services reflected the needs of this population group. Patients were also able to order repeat prescriptions via email or in person at the practice Extended opening hours for appointments were available on a Tuesday morning and patients who were unable to attend the surgery were able to speak with a GP over the telephone who would give advice or arrange an appointment as necessary. NHS health checks for people aged between 40 and 74 years of age were undertaken as well as a range of health promotion and screening services which reflected the needs for this age group. Lifestyle advice was offered such as advice on smoking cessation.

Women were given advice and information about cervical screening programs. However, the practice’s performance for cervical screening was 2% lower than the average in the area. The practice were aware that they were lower than local averages regarding the blood pressure monitoring of patients with hypertension and had taken some action to try and address this issue.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 June 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations including MIND. A mental health link worker visited the practice twice per month and patients could then be referred to the Early Access Service (EAS) to enable GPs to access services in Secondary Care.

Clinical staff were aware of the Mental Capacity Act and were able to describe how they implemented it in their practice. These staff had undertaken Mental Capacity Training.

The practice had been identified as worse than average and at an elevated risk regarding some QOF targets, for example the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months and the percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months. The practice were aware of these issues and had plans in place to address but at the time of inspection had not started working on these identified risks. QOF is the annual reward and incentive programme which awards practices achievement points for managing some of the most common chronic diseases, for example asthma and diabetes.

People whose circumstances may make them vulnerable

Good

Updated 11 June 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients and had sign posted vulnerable patients to various support groups and third sector organisations. 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 agencies in and out of hours. The practice offered longer appointments for people with learning disabilities.

Patients had access to an interpreting service if English was not their first language so that they could have a consultation with the GP in a language they understood.