• Doctor
  • GP practice

Archived: Stoneleigh Surgery

Overall: Good read more about inspection ratings

Police Square, Milnthorpe, Cumbria, LA7 7PW (015395) 63307

Provided and run by:
Stoneleigh Surgery

Latest inspection summary

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Background to this inspection

Updated 27 January 2017

Stoneleigh Surgery provides Primary Medical Services to the town of Milnthorpe and surrounding villages in an approximate six-mile radius of the town. The practice provides services from one location at Police Square, Milnthorpe, Cumbria, LA7 7PW. We visited this address as part of the inspection. The practice is a dispensing surgery. This means under certain criteria they can supply eligible patients with medicines directly.

The surgery is located in a converted three storey building. Disabled facilities are limited and there is no car parking at the surgery. Adaptations have been put in place where possible and space is a challenge. The practice have put forward a bid with the backing of the local clinical commissioning group (CCG) for a new health centre to accommodate themselves and another GP practice in Milnthorpe.

The practice has six GP partners of which five are part-time and one full time. Four are female and two male. The practice is a training practice who have GP trainees allocated to the practice (fully qualified doctors allocated to the practice as part of a three-year postgraduate general practice vocational training programme).There is a practice manager, a medicines manager, five dispensary staff, three practice nurses, two health care assistants, a phlebotomist who also works as a receptionist and ten reception and administration staff.

The practice provides services to approximately 6,600 patients of all ages. The practice is commissioned to provide services within a General Medical Services (GMS) contract with NHS England.

The practice is open from 8am until 6.30pm Monday to Friday. There is extended opening hours on a Tuesday evening 6.30 until 7.30pm and on Monday, Wednesday and Friday morning from 7.30am. The surgery is also open once a month on a Saturday morning from 8am until 12 noon.

Consulting times with the GPs and nurses range from 8am until 11am, 2pm until 4pm and 5pm until 6pm. On evenings when extended hours are available from 6.30pm until 7.30pm, on mornings from 7.30am and from 8am until 12 noon on one Saturday morning per month. The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Cumbria Health On Call (CHOC).

Information taken from Public Health England placed the area in which the practice was located in the tenth least deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The average male life expectancy is 82 years and the female is

84. Both of these are higher than the CCG average and national averages. The average male life expectancy in the CCG area is 79 and nationally 79. The average female life expectancy in the CCG area is 82 and nationally 83. The practice has a higher percentage of patients over the age of 50, when compared to national averages. There are fewer patients than average aged between 20 and 44. The percentage of patients reporting with a long-standing health condition is higher than the national average Stoneleigh Surgery (practice population is 60% compared to a national

average of 54%). The proportion of patients who are in paid work, full-time employment or education is 49% compared to the CCG average of 59% and the national average of 61.5%

Overall inspection

Good

Updated 27 January 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced inspection of this practice on 28 April 2016. Breaches of legal requirements were found. Overall, we rated the practice as requires improvement.

After the comprehensive inspection the practice wrote to us to say what they would do to address four identified breaches of regulation. We undertook this comprehensive inspection on 8 November 2016 to check that the practice had followed their plan and to confirm that they now met legal requirements. You can read the report from our last comprehensive inspection and our focused inspection by selecting the ‘all reports’ link for Stoneleigh Surgery on our website at www.cqc.org.uk.

Overall the practice is now rated as good.

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

  • The practice had taken action to address the concerns raised at the CQC inspection in April 2016. They had developed a clear vision, strategy and plan to deliver high quality care and promote good outcomes for patients.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and 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.
  • 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.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 27 January 2017

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.
  • Performance for diabetes related indicators was better than the national average. For example, the practice had achieved 100% of the points available, compared to the national average of 89.9%.
  • 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 27 January 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 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.
  • Performance for asthma related indicators was better than the national average. For example, the practice had achieved 100% of the points available, compared to the national average of 97.4%
  • 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 27 January 2017

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.
  • Performance for conditions which typically affect older patients, such as chronic obstructive pulmonary disease (COPD) was better than the national average. For example, the practice had achieved 100% of the points available, compared to the national average of 95.9%

Working age people (including those recently retired and students)

Good

Updated 27 January 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 and the practice had adjusted the services it offered 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.
  • The practice’s uptake for the cervical screening programme was 86%, which was higher than the CCG and national average of 82%.

People experiencing poor mental health (including people with dementia)

Good

Updated 27 January 2017

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

  • Performance for mental health related indicators was better than the national average. For example, the practice had achieved 97.7% of the points available, compared to the national average of 92.9%.
  • 81% 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 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 27 January 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, travellers 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.