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Stanley Corner Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 11 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanley Corner Medical Centre on 8 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The provider was aware of and complied with the requirements of the duty of candour.
  • Risks to patients were assessed and well managed.
  • 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. There was a strong emphasis on health promotion and prevention. The practice ensured staff had access to relevant training and learning opportunities to maintain their skills.
  • Patients said they were treated with compassion and respect and they were involved in decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns and affected patients received an apology.
  • Most patients we spoke with said they found it easy to make an appointment. Urgent appointments were available the same day. The practice promoted continuity of care for patients with long term conditions, older patients and those in vulnerable circumstances.
  • There was a clear leadership structure and staff felt supported by management. The practice had a strategic approach to managing long-term conditions and reviewing its performance. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

  • The premises were generally well maintained and pleasant. However, the first floor waiting room was quite bare with poor quality seating. This should be improved at an appropriate opportunity.

We saw one area of outstanding practice:

  • The practice had a good track record in encouraging eligible patients to have their annual flu immunisation. The practice organised an annual 'flu jab' open day. Information about the day was displayed in the practice and elsewhere locally. On the day, the practice staff wore custom designed t-shirts, and put up posters, displays and laid on refreshments to publicise the event and catch patients' attention. Staff described it as a fun, informal event with a positive purpose.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 July 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 things went wrong patients received reasonable support, truthful information, and a 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.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 11 July 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average 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 most staff. Two outstanding appraisals had been scheduled.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 11 July 2016

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice highly.
  • Patients said they were treated with compassion 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.
  • Staff treated patients with kindness and respect, and maintained patient confidentiality.
  • Patients received sensitive care and support towards the end of life or following bereavement.

Responsive

Good

Updated 11 July 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, clinical commissioning group and the GP locality group to secure improvements to services where these were identified.
  • Most patients said they found it easy to make an appointment when they needed one. Urgent appointments were available the same day.
  • 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 and other stakeholders.

Well-led

Good

Updated 11 July 2016

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

  • The practice had a clear vision and strategy which it shared with patients. Staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff felt supported by management.
  • The practice had policies and procedures to govern activity and held regular governance meetings. Governance included arrangements to monitor and improve quality and identify risk.
  • The partners encouraged a culture of openness and honesty. The practice had systems in place to notify patients and their representatives about notifiable safety incidents under the duty of candour.
  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.
  • There was a strong focus on continuous learning and improvement at all levels. The practice was a training and teaching practice.
  • The trainee GPs were very positive about their experience at the practice and said it was a good place to work and to learn.
Checks on specific services

People with long term conditions

Good

Updated 11 July 2016

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

  • The medical and nursing staff members had lead roles in chronic disease management.
  • Longer appointments and home visits were available when needed.
  • Patients with long-term conditions had a structured annual review to check their health and medicines needs were being met. The practice was achieving or close to achieving the maximum Quality and Outcome Framework points for its management of all long-term conditions apart from diabetes.
  • The diabetic specialist nurse attended the practice each month to review patients whose diabetes was not well controlled.
  • The practice provided in-house phlebotomy. The practice had arranged extended hours diabetes foot checks and spirometry testing.
  • 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.
  • Patients at risk of hospital admission were identified as a priority. The practice liaised with the local rapid response services to provide urgent support at home when required.
  • The practice took steps to inform staff when patients were receiving difficult news to ensure these patients received time and support from the whole team.

Families, children and young people

Good

Updated 11 July 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 who had a high number of A&E attendances.
  • Staff were able to provide examples of how they treated children and young people in an age-appropriate way and respected the confidentiality of young people.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • Young children and babies who were unwell were seen the same day.
  • The practice provided antenatal checks, the six week postnatal check and weekly baby clinics. The practice team had effective links with the local health visitors.
  • The practice ran weekly asthma clinics and had reviewed asthma control in 79% of practice patients with an asthma diagnosis (national average 75%).
  • One of the partners advocated the relevant authorities for the continuation of a local service for young people in Brent having seen a positive impact on patients.

Older people

Good

Updated 11 July 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. All patients aged over 75 were allocated a named GP and continuity of care was encouraged and facilitated by reception staff.
  • The practice was responsive to the needs of older people, and offered home visits and urgent or longer appointments for those with enhanced needs or in vulnerable circumstances. The practice offered telephone consultations for elderly patients who wanted advice and could not get an appointment on the day.
  • The practice carried out clinical audit relevant to older patients, for example, recently auditing its management of osteoporosis and falls assessment.
  • One of the GPs had the diploma in geriatric medicine and was the practice lead for end of life care.

Working age people (including those recently retired and students)

Good

Updated 11 July 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 and flexible.
  • GP consultations were available until 7:45pm one evening a week.
  • Patients were able to book appointments online and the practice offered an electronic prescription service.
  • The practice offered a full range of health promotion and screening reflecting the needs of this age group including NHS health checks for patients aged 40-74. The practice had identified patients with previously undiagnosed diabetes through these checks.
  • The practice offered access to travel advice and vaccinations; family planning services (including coil fitting) and cervical screening. The practice coverage for the cervical screening programme was 83% which was higher than the national average.
  • Students were able to remain registered with the practice if they preferred throughout the academic year.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 July 2016

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

  • The practice had 21 patients with a diagnosis of dementia. Fourteen had attended a face to face review of their care in the last year. The practice screened patients at risk of dementia and referred patients to a local memory clinic for further investigation and diagnostic tests.
  • The practice regularly worked with multi-disciplinary teams in the care planning of patients experiencing poor mental health and those with dementia.
  • Distressed patients who are known to have mental health issues were offered appointments or telephone consultations the same day. An note was added to the electronic patient record to alert receptionists if patients preferred to see a specific doctor.
  • 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.
  • Patients with mental health needs were offered longer appointments or consultations at the end of the session. The practice also facilitated continuity of care for these patients.
  • Patients had access to the local IAPT (Improving Access to Psychological Therapies).
  • The practice advised patients experiencing poor mental health how to access various support groups and voluntary organisations.

People whose circumstances may make them vulnerable

Good

Updated 11 July 2016

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

  • The practice held registers of patients living in vulnerable circumstances including people with a learning disability.
  • The partners were able to provide examples of how the practice had responded flexibly to the needs of individuals in very high need with positive and, in some cases life changing, outcomes.
  • The practice maintained a register of patients who were also carers.
  • 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 and cases were discussed in practice and multidisciplinary team meetings.
  • 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.
  • The practice enabled patients to register regardless of their circumstances and had a diverse patient list, including for example, travellers and homeless patients.
  • The practice team could speak a range of languages including Hindi, Gujarati, Italian, Farsi and Urdu. This was particularly valued by some older patients who spoke these languages.