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Waterside Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 11 May 2018

This practice is rated as Good overall. (Previous inspection March 2016 –Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Waterside Medical Centre on 17 March 2016. The overall rating for the practice was good. However the key question Safe was rated as requires improvement. The full comprehensive report can be found by selecting the Waterside Medical Centre ‘all reports’ link  on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 20 March 2018

to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 17 March 2016. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 May 2018

Effective

Good

Updated 11 May 2018

Caring

Good

Updated 11 May 2018

Responsive

Good

Updated 11 May 2018

Well-led

Good

Updated 11 May 2018

Checks on specific services

People with long term conditions

Good

Updated 15 June 2016

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

  • The practice was an outlier for the QOF indicator in Chronic Obstructive Pulmonary Disease (COPD). There was 0.25 ratio of reported versus expected prevalence for COPD (national average 0.63).
  • The practice held health promotion campaigns to engage and educate patients on long term conditions. For example, the practice had carried out events on diabetes and asthma in the past 12 months.
  • Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
  • Performance for diabetes related indicators was similar to the national average. For example, 70% of patient with diabetes on the register had a blood pressure reading of 140/80 mmHg or less in their latest test in the preceding 12 months (national average 78%).
  • Longer appointments and home visits were available when needed.
  • People with long term conditions had a structured annual review to check their health and medicines needs were being met. For those people with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 15 June 2016

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 who were at risk. For example, children and young people who had a high number of A&E attendances.

  • Immunisation rates were relatively high for all standard childhood immunisations.
  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
  • The practice’s uptake for the cervical screening programme was 69%, which was comparable to the CCG average of 67% and the national average of 74%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • We saw positive examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 15 June 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.
  • All people over the age of 75 years had a named GP to provide continuity of care.
  • All people over the age of 90 years were included on the vulnerable persons register and were reviewed regularly.

Working age people (including those recently retired and students)

Good

Updated 15 June 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.
  • Appointments were available on Monday and Thursday evening, and Saturday morning, which ensured working people could book an appointment to see a doctor out of working hours.
  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 15 June 2016

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

  • All five patients with dementia had had their care reviewed in a face-to-face meeting in the last 12 months, which is better than the national average.
  • Performance for mental health related indicators was similar to the national average. For example, 92% of patients with schizophrenia, bipolar affected disorder and other psychoses had had a comprehensive, agreed care plan documented in their records in the preceding 12 months.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
  • The practice was part of the Ealing CCG Pilot Scheme, ‘Shifting Settings of Care’. This provided more support for patients with mental health conditions to be treated in the practice with additional support from the mental health worker.
  • The practice carried out advance care planning for patients with dementia.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 15 June 2016

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 including people who were housebound and people with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • The practice informed vulnerable patients about how to access various support groups and voluntary 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 normal working hours and out of hours.