Archived: Rough Hay Surgery

Updated 9 April 2015

Rough Hay Surgery is based in the Walsall Clinical Commissioning Group (CCG) The practice provides primary medical services to approximately 3200 patients in the local community.

On the day of our inspection the practice had two GPs and a trainee GP. Additional staff included a practice manager, two practice nurses and administrative staff who supported the practice

The practice offered a range of clinics and services including asthma, diabetes and Immunisations.

The practice had opted out of providing its own out of hours cover. This was provided by the Badger Group. The practice answer phone directed patients to this service outside of surgery hours.

Updated 9 April 2015

We completed a comprehensive inspection at Rough Hay Surgery on 22 October 2014. The overall rating for the practice is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to people with long term conditions, families, children and young people, working age people, older people, people in vulnerable groups and people experiencing poor mental health.

Our key findings were as follows:

• Patients were protected from the risk of abuse and avoidable harm. The staff we spoke with understood their roles and responsibilities and there were policies and processes in place for safeguarding children and vulnerable adults.

• Patients received care and treatment to support good outcomes which promoted a good quality of life.

• Staff were caring and treated patients with dignity and respect.

• Patients were complimentary of the care and treatment that they received.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice sought feedback from staff and patients and this was acted upon.

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

The provider should:

• Complete a risk assessment to ascertain if any action is required to ensure safety in relation to legionella (a germ found in the environment which can contaminate water systems in buildings).

• Review the staff group’s knowledge and understanding regarding the chaperone process to ensure it reflects the 2013 published General Medical Council (GMC) guidance for ‘Intimate examinations and chaperones’
• Review the current process and schedule for staff appraisals to ensure that all staff receives supervision and appraisals regularly.

Professor Steve Field CBE FRCP FFPH FRCGP

Updated 9 April 2015

The practice is rated as good for the population group of people with long term conditions. Processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. Where appropriate patients had a named GP. Reviews were monitored to check their health and medication needs were being met. For those people with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

To further support patients with long term conditions the practice used the information they collected for the quality outcome framework (QOF). QOF is a national performance measurement tool. This system allowed for staff to identify patients requiring a review of their condition and/or medication.

The practice used computerised tools to identify patients with complex needs. The staff discussed the process the practice used to review patients recently discharged from hospital which required patients to be reviewed.

Updated 9 April 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying children living in disadvantaged circumstances and who were at risk. Immunisation rates were generally in line with those expected for all standard childhood immunisations.

Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with midwives, health visitors and school nurses.

The practice had a dedicated GP appointed as lead in safeguarding children who had been received the appropriate training to fulfil this role. The staff we spoke with were aware who the lead was and who to speak to in the practice if they had a safeguarding concern

Updated 9 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example end of life care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs and home visits.

Patients in this population group reported good access to the practice with a named GP for continuity of care.

The practice used computerised tools to identify patients with complex needs. Care planning for these patients had been introduced and the nurse discussed the benefits to further developing this system. The staff discussed the process the practice used to review patients recently discharged from hospital which required patients to be reviewed.

Updated 9 April 2015

The practice is rated as good for the population group of the 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 offer continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group.

The practice made all relevant referrals through the Choose and Book system. The Choose and Book system enables patients to choose which hospital they will be seen in and to book their own outpatient appointments at a convenient time for them, in discussion with their chosen hospital. These may be beneficial to patient who have commitments such as work and education.

Updated 9 April 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). The clinical staff spoke were knowledgeable about the support the practice offered to patients who may be experiencing poor mental health. We saw that staff were able to identify and respond to changing risks to patients including deteriorating health and well-being or medical emergencies. We were given an example of how the GP had responded to a patient experiencing poor mental health, including supporting them to access community care and treatment

We found that the clinical staff we spoke with were aware of the Mental Capacity Act 2005 and their duties in fulfilling it and were able to describe how they implemented it in their practice.

Updated 9 April 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances, for example those with learning disabilities. However register the practice were unable to clarify how many patients had received an annual physical health check. The practice nurse agreed this was an area requiring review.

The practice had a dedicated GP appointed as lead in safeguarding vulnerable adults. 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 and out of hours.

The practice held multidisciplinary team meetings quarterly to discuss the needs of complex patents for example, those with end of life care needs or children on the at risk register. These meetings were attended by palliative care nurses in order to discuss care planning