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St James Medical Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 16 April 2015

Letter from the Chief Inspector of General Practice

St James Medical Practice serves a population of approximately 5000 patients.

We carried out a comprehensive inspection at St James Medical Practice on 27 January 2015.

We found that the practice provided a safe, effective, caring, responsive and well led service for the population it served. The overall rating was good and this was because the practice staff demonstrated enthusiasm and worked together in providing good standards of care for patients.

Our key findings were as follows:

  • Practice staff worked together as a team to ensure co-ordinated patient care.

  • The practice was visibly clean. The standards of hygiene were regularly monitored to protect patients from unnecessary infections.

  • There was a register of all vulnerable patients who were reviewed regularly. Patients we spoke with told us they were satisfied with the care they received and their medicines were regularly reviewed.

  • The practice was able to demonstrate a good track record for safety. Effective systems were in place for reporting safety incidents. Untoward incidents were investigated and where possible improvements made to prevent similar occurrences.

  • We found that patients were treated with respect and their privacy was maintained. Patients informed us they were very satisfied with the care they received but some reported their inability to book an appointment when they felt they needed to.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

  • Review the appointments system to enable patients to book appointments when they need them.
  • Develop protocols for auditing the medicines GP’s carried in their bags to ensure they were safe for administration when visiting patients in their homes.
  • Engage with patients by carrying out annual surveys to gather feedback on the quality of the service provided and respond to them in order to make improvements.
  • Implement a system of regular checks regarding nurse’s registration with their respective professional body to ensure they were practicing legally.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 16 April 2015

The practice is rated as good for providing safe services. The practice had a good track record for safety. There was effective recording and analysis of significant events and lessons learnt were cascaded to all relevant staff for prevention of recurrences. There were robust safeguarding measures in place to help protect children and vulnerable adults. Reliable systems had been arranged for safe storage and use of medicines and vaccines within the practice. There was a designated lead to oversee the hygiene standards within the practice to prevent infections.

Effective

Good

Updated 16 April 2015

Clinicians worked within both the National Institution for Care Excellence (NICE) guidelines and other locally agreed guidelines. Patient’s needs were assessed and care planned and delivered in line with current legislation. Clinicians carried out clinical audits and as a result made changes where necessary to promote effective treatments for patients. Systems were in place for regular reviews of patients who had long term conditions, those identified as at risk and housebound patients. Multidisciplinary working was evidenced.

Caring

Good

Updated 16 April 2015

The practice is rated as good for providing caring services. Patients were treated with compassion, dignity and respect and they were involved in their care and treatment decisions. Accessible information was provided to help patients understand the care available to them. Reception staff treated patients with kindness and respect ensuring confidentiality was maintained. We observed staff interacting with patients in a caring and supportive way. Accessible information was provided to help patients understand the care that was available to them.

Responsive

Good

Updated 16 April 2015

The practice demonstrated how they listened to and responded to their patient group. We saw that efforts had been made to reach out to each population group to ensure they received appropriate care and treatments. The practice had good facilities and was well equipped to assess and treat patients in meeting their needs. There was an accessible complaints system with evidence demonstrating that the practice responded appropriately and in a timely way.

Well-led

Good

Updated 16 April 2015

The practice is rated as good for providing well-led services. Practice staff listened to and responded to the needs of patients. We saw that efforts had been made to reach out to each population group to ensure they received appropriate care and treatments. High standards were promoted and owned by all practice staff with evidence of team working across all roles. Governance and performance management arrangements were in place to promote best practice.

Checks on specific services

People with long term conditions

Good

Updated 16 April 2015

The practice is rated as good for care of people with long term conditions. Practice staff held a register of patients who had long term conditions and carried out regular reviews. There was a recall system in place when patients failed to attend for their reviews. For patients with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Emergency processes were in place and referrals were made for patients in this group that had a sudden deterioration in health. The practice specifically reviewed all hospital admissions so that lessons could be learnt.

Families, children and young people

Good

Updated 16 April 2015

The practice is rated as good for the care of families, children and young people. Appointments were available outside of school hours and the premises were suitable for children and babies. Practice staff liaised with local health visitors to offer a full health surveillance programme for children. Checks were also made to ensure maximum uptake of childhood immunisations. The nursing team offered immunisations to children in line with the national immunisation programme. Alerts and protection plans were in place to identify and protect vulnerable children.

Older people

Good

Updated 16 April 2015

The practice is rated as good for care of older people. All patients aged over the age of 75 years had been informed of their named and accountable GP. GPs provided care to patients who resided in four care homes and one assisted living accommodation. The practice offered proactive, personalised care to meet the needs of its population. Practice staff were responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 16 April 2015

The practice is rated as good for the care of working age people (including those recently retired and students). Community midwives held regular ante natal and post natal clinics at the practice. The practice offered extended opening hours to assist this patient group in accessing the practice. Appointments were available 6:30pm until 8pm Mondays and 7:30am until 8am Tuesday, Wednesday and Thursday mornings. Some Saturday morning clinics had commenced in December 2014.

People experiencing poor mental health (including people with dementia)

Good

Updated 16 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Care was tailored to patients’ individual needs and circumstances including their physical health needs. Patients who presented with anxiety and depression were assessed and managed within with the National Institute for Clinical Excellence (NICE) guidelines. Annual health checks were offered to patients who had serious mental illnesses. GPs had the necessary skills and information to treat or refer patients with poor mental health. Practice staff worked in conjunction with the local mental health team to ensure patients had the support they needed. The practice participated in the local enhanced scheme for patients with dementia to ensure regular reviews were carried out and care plans were developed.

People whose circumstances may make them vulnerable

Good

Updated 16 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Practice staff had identified patients with learning disabilities and treated them appropriately. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. GPs carried out regular home visits to patients who were housebound and to other patients on the day they had been requested.