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Woolpit Health Centre Good Also known as Dr Pearson & Partners

Inspection Summary


Overall summary & rating

Good

Updated 31 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woolpit Health Centre on 5 December 2016. The overall rating for the practice was good, with requires improvement for providing safe services. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Woolpit Medical Practice on our website at

www.cqc.org.uk

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We undertook a desk-based focused inspection to check they had followed their action plan and to confirm they now met legal requirements in relation to the breach identified in our previous inspection on 5 December 2016. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good.

Our key findings were as follows:

  • The practice had an effective system in place for monitoring the medicines in GPs bags.

  • The practice had updated the medicines searches that were completed quarterly, to ensure that prescribing was in accordance with current best practice. There was an effective policy in place for patients on high risk medicines who had declined to attend for a review.

  • Security arrangements for the dispensary had been reviewed and improved. Standard operating procedures had been reviewed and a system was in place to ensure this was completed on a regular basis and dispensing errors were discussed at team meetings.

  • The practice had updated the training matrix to include infection control which had been completed by all staff. Infection prevention and control training was booked for July 2017.

Appraisals for most staff had been undertaken. Staff teams undergoing a restructure had undergone an informal appraisal process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 31 May 2017

At the last inspection on 5 December 2016 we found that:

There was not an effective process in place to ensure medicines in GP bags were in date. We also found that the provider should undertake repeat searches for historic patient safety alerts which may remain relevant and have a process in place for patients on high risk medications who declined to attend for a review. The practice should have reviewed a number of the standard operating procedures and review security arrangements for the dispensary. The practice should have discussed dispensing errors identified within the practice and undertaken audits to ensure the quality of the dispensing service and ensure all staff had received infection control and prevention training.

 

Our desk-top focused inspection on 18 April 2017 found that:

  • The practice had an effective system in place for monitoring the medicines in GPs bags. There was a clear log, identifying the dates that medicines expired and this had been implemented effectively.

  • The practice had updated the drug related searches that were completed quarterly to include historic patient safety alerts.

  • There was an effective policy in place for patients on high risk medications who had declined to attend for a review.

  • Security arrangements for the dispensary had been reviewed and improved. Standard operating procedures had been reviewed and a system was in place to ensure this was completed on a regular basis. There was a procedure in place to ensure dispensing errors were discussed at meetings.

The practice had updated the training matrix to include infection control and continued to liaise with the local infection control and prevention teams to keep up to date with best practice. Infection prevention and control training had been booked for July 2017.

Effective

Good

Updated 31 May 2017

Caring

Good

Updated 31 May 2017

Responsive

Good

Updated 31 May 2017

Well-led

Good

Updated 31 May 2017

Checks on specific services

People with long term conditions

Good

Updated 1 March 2017

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

  • The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2015/2016 showed that performance for diabetes related indicators was 100%, which was above the CCG average of 96% and national average of 90%. Exception reporting for diabetes related indicators was 5% which was below the local average of 12% and the national average of 11% (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
  • Longer appointments and home visits were available when needed.
  • Patients with complex needs 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.
  • The nursing team held clinics to review patients with diabetes. These clinics were also attended by West Suffolk Hospital Diabetes Specialist Nurses, to provide intervention for those patients whose needs were more complex.
  • The practice pharmacist offered support to patients with long term conditions. For example, explaining the use of medicines devices and ensuring that patients understood medicines regimes.
  • The GPs gave their mobile telephone contact numbers to patients who were nearing the end of their life. This enabled patients and/or their family members to call the GP in the evening and at weekends.

Families, children and young people

Good

Updated 1 March 2017

The practice is rated as good for the care of families, children and young people.

  • Immunisation rates were in line with the CCG and national average for all standard childhood immunisations. The practice had identified that immunisation rates for children from traveller families were low and had worked with the health visitor to improve this.
  • A daily emergency surgery was available for patients if they felt their need was urgent. This included appointments for children and young people. We received positive feedback about the appointment system from two patients who we spoke with who attended with their children.
  • 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.
  • The practice offered a full range of contraception services.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • The practice had baby changing and breast feeding facilities available.
  • We saw positive examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 1 March 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.
  • Clinical staff provided home visits to patients living in the nursing home covered by the practice.
  • Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis, dementia and heart failure were above the local and national averages.

Working age people (including those recently retired and students)

Good

Updated 1 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 and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. Early morning, early evening and Saturday appointments as well as telephone consultations were available.
  • Patients were able to book evening and weekend appointments with a GP through Suffolk GP+ (Suffolk GP+ is for patients who urgently need a doctor’s appointment, or are not able to attend their usual GP practice on a weekday.)
  • 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 percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 82%, which was the same as the local and national average. The exception rate was 2% which is lower than the CCG average of 5% and the national average of 7%.

People experiencing poor mental health (including people with dementia)

Good

Updated 1 March 2017

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

  • 96% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is better than the local average of 85% and national average of 84%.
  • 97% of patients experiencing poor mental health had a comprehensive care plan, which was above the local and national average of 89%.
  • The practice had a primary mental health care link worker who undertook a weekly surgery at the practice and offered signposting to secondary care services and advocacy for patients to access the appropriate service.
  • Staff from the Improving Access to Psychological Therapy (IAPT) service attend every week and accepts referrals from the GP and self referrals.
  • The practice held monthly multidisciplinary meetings where patients with complex mental health needs were discussed and care plans agreed. The practice worked closely with the Consultant Psychiatrist who would attend the practice to discuss and agree care plans for those patients with the most complex mental health needs.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • 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 1 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, travellers and those with a learning disability.
  • The practice supported patients who were not able to read or write to complete necessary forms, for example when they registered at the practice.
  • The practice had 37 patients on the learning disabilities register. Last year 28 out of the 37 patients had received a care review. 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.
  • The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 384 patients as carers (3% of the practice list).