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Handsworth Wood Medical Centre Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 6 April 2018

We previously carried out an announced comprehensive inspection at Handsworth Wood Medical Centre on 6 January 2017. The overall rating for the practice was good, with a requires improvement rating for providing responsive services. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Handsworth Wood Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 28 February 2018 to confirm that the practice had carried out improvements in relation to the areas of concern we identified in our previous inspection on 6 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

  • We saw there was appropriate information for carers to direct them to other avenues of support.
  • The practice had discussed national GP patient survey results and devised actions to try and improve areas of poor satisfaction.

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

The provider should:

  • Continue to explore options to improve telephone access further.
  • Continue to monitor the effectiveness of actions taken to improve patient satisfaction.
  • Continue to advertise appointment times and ways to access the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 10 March 2017

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.

  • 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.

  • Emergency medicines were easily accessible to staff in a secure area of the practice and all staff knew of their location. The medicines we checked were in date and stored securely, however we found that the practice did not stock intravenous chlorphenamine (a drug given to treat “anaphylaxis” a type of allergic reaction), the practice did however hold medication which could be taken orally and later informed us that this was now in place.

Effective

Good

Updated 10 March 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework 2015 -16 (QOF) showed patient outcomes were better than national averages.

  • 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.

  • However, the service did not always accurately record the training staff had received.

  • There was evidence of appraisals and personal development plans for all staff.

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

Caring

Good

Updated 10 March 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice similar to others for several aspects of care.

  • 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 6 April 2018

Well-led

Good

Updated 10 March 2017

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

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for 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 a number of policies and procedures to govern activity and held regular governance meetings.

  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty. The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken

  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

Checks on specific services

People with long term conditions

Good

Updated 10 March 2017

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

  • The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

  • Data from 2015 to 2016 showed that the practice was performing above average in comparison with other practices nationally for the care and treatment of people with chronic health conditions such as diabetes.

  • Performance for diabetes related indicators were better than the local and national average. For example: the percentage of patients on the diabetes register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less (01/04/2015 to 31/03/2016) was 87% compared to Clinical Commissioning Group (CCG) average of 78% and the national average of 78%.

  • For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

  • Longer appointments and home visits were available when needed. We saw that staff knew the practice population well and ensured any patients needing longer appointments had access to these when necessary.

  • All these patients had a named (usual) 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 10 March 2017

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 above average 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.

  • Data showed that 81% of female patients aged 25-64 attended cervical screening within the target period which was comparable with the national average.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • We saw evidence of joint working with midwives, health visitors and school nurses.

  • The practice also provided GP services to students at the University of Birmingham and offered specific registration weekends for students.

Older people

Good

Updated 10 March 2017

The practice is rated as good for the care of older people.

  • The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

  • Patients over the age of 75 had a named GP and had received a review to check that their health needs were being met.

  • Care planning was carried out for patients with dementia care needs.

  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Data showed that outcomes, for conditions commonly found in older people, were comparable to those found nationally..

  • The practice provided clinics at a number of nearby nursing and residential care homes.

Working age people (including those recently retired and students)

Good

Updated 10 March 2017

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 by the practice, and services had been adjusted to ensure these were accessible, flexible and offered continuity of care.

  • 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. Online services included the booking of appointments and request for repeat prescriptions.

  • Extended hours appointments were provided daily until 8pm each evening. Patients were offered telephone consultations for those patients who preferred to call the GP. This was advantageous for people in this group as it meant they did not always have to attend the practice in person.

People experiencing poor mental health (including people with dementia)

Good

Updated 10 March 2017

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

  • Data about how people with mental health needs were supported showed that outcomes for patients using this practice were lower thanlocal and national averages. For example, data showed that 71% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was lower than the clinical commissioning group and national average of 84%.

  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

  • 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 10 March 2017

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 homeless people who were encouraged in to register using the practice as a home address and those 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.