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Weelsby View Health Centre - Drs Chalmers and Meier Good

Inspection Summary


Overall summary & rating

Good

Updated 14 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 19 May 2016. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:

Fit and proper persons employed

How the regulation was not being met:

Recruitment arrangements did not include all necessary employment checks for all staff.

Regulation 19(3)(a) schedule 3

This inspection was a desk-based review carried out on 21 February 2017 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 19 May 2016. This report covers our findings in relation only to those requirements.

The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for Bartholomew Medical Group on our website at www.cqc.org.uk.

Overall the practice is rated as good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 March 2017

At our previous inspection we found that not all clinical staff had received a Disclosure

and Barring Service check and no risk assessment to support the decision, had been undertaken so the practice could not provide complete assurance that all the clinical staff they employed did not pose any potential risk to patients.

We checked and found that the practice now had a system in place to risk assess clinical staff who had not undergone a DBS check. These members of staff had been employed in the practice for many years. For new staff a DBS check would be undertaken.

The risk assessments included the person’s name, their role, length of time employed at the practice, whether they had been subject to any criminal convictions, cautions or any investigations by any organisation. Also included was whether a DBS check had been undertaken before and if the person worked with vulnerable adults or children.

Staff are also required to inform the registered person at the practice of any changes to their personal circumstances, health, and criminal or otherwise, which may affect their suitability for continued employment. All staff have a clause in their contract for criminal offences in their contract and must report any incident.

Effective

Good

Updated 11 August 2016

The practice is rated as good for providing effective services. Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were mostly in line with national averages. The practice had lower achievement rates for patients with diabetes who needed to have their cholesterol measured or needed a foot examination. However, the practice told us that there was a problem with the QOF data, following a change to their computer systems, with their exception rates showing as higher than they actually were.

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 staff. Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 11 August 2016

The practice is rated as good for providing caring services. Data from the national GP patient survey showed patients rated the practice in line with other practices for some aspects of care including patients having confidence and trust in the last GP they saw and that the last nurse they spoke to was good at treating them with care and concern and involving them in decision about their care. In some areas the practice was rated as slightly lower than other practices, this included patients having enough time with the GP. However, overall patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. 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 August 2016

The practice is rated as good for providing responsive services. Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified. For example screening patients for high blood pressure.

Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. However, it would be difficult for patients to obtain accurate details of appointment times as the information contained in the practice’s guide to services, the website and NHS Choices was either incomplete or contradictory.

The practice had good facilities and was well equipped to treat patients and meet their needs.  Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. 

Well-led

Good

Updated 14 March 2017

At our previous inspection of 19 May 2016 we rated the practice as good for well led. It was noted that the practice did not have an established Patient Participation Group. The practice remains as being rated as good for well led.

We looked at information provided by the practice to show they were actively looking to find patients to form a Patient Participation Group. However whilst the practice have a video showing in their waiting room several times a day and also asking patients if they would be interested in forming a Patient Participation Group they have not yet been successful. However they are continuing to try to get this up and running.

Checks on specific services

Older people

Good

Updated 11 August 2016

The practice is rated as good for the care of older people. The GPs in the practice had personal lists and would whenever possible ensure continuity of care with patients seeing the same GP. 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.

People with long term conditions

Good

Updated 11 August 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

Nationally reported data for 2014/2015 showed that the practices performance across a range of diabetes related indicators was similar to the national average for some of the indicators. For example 90% of their patients with diabetes had received an influenza injection compared to the national average of 94%. However, performance was worse than the national averages for the measurement of cholesterol and recording of foot examinations. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 11 August 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 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. Nationally reported data for 2014/2015 showed that the practice was in line with national averages for rates of cervical screening. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw examples of joint working with midwives, health visitors and school nurses.

Working age people (including those recently retired and students)

Good

Updated 11 August 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 offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

People whose circumstances may make them vulnerable

Good

Updated 11 August 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 those with a learning disability. It offered longer appointments for patients with a learning disability and regularly worked with other health care professionals in the case management of vulnerable patients. It 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.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 84% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average. Overall the practice performance across a range of mental health related indicators was comparable to the national averages. The practice worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Staff had a good understanding of how to support patients with mental health needs and dementia.