Archived: Dr John Roberts + Dr David Longford Also known as Dr J W Roberts + Dr David Longford

Updated 5 April 2016

Dr. John Roberts + Dr. David Longford is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post natal care. The practice is situated within the Walton area of Liverpool. This area has higher than average deprivation scores for income, employment, healthcare and deprivation affecting children and older people. The practice has a Primary Medical Services (PMS) contract with a registered list size of 3605 patients (at the time of inspection). The practice has one GP partner and two salaried partners. At the time of our inspection Dr David Longford had left the practice. The practice also had two practice nurses, a practice manager and a number of administration and reception staff. The practice is also a training practice for trainee GPs and medical students.

The practice is open between 8am to 6.30pm Monday to Friday with appointments bookable in a variety of ways. Home visits and telephone consultations were available for patients who required them, including housebound patients and older patients. There were also arrangements to ensure patients received urgent medical assistance when the practice was closed. If patients called the practice when it was closed, an answerphone message gave the telephone number they should ring to obtain healthcare advice or treatment.

Updated 5 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr. John Roberts + Dr. David Longford on 17 November 2015. Overall the practice is rated as good.

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

• Systems were in place to ensure incidents and significant events were identified, investigated and reported. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• The practice did not have an external automated defibrillator (AED) and oxygen equipment available for use in an emergency situation, (an AED is a portable electronic device that diagnoses life threatening irregularities of the heart and is able to deliver a shock to attempt to correct the irregularity.)

• Staff who undertook a chaperone role did not have a Disclosure and Barring Service (DBS) check. Safeguarding training had not been completed for all staff.

• There was incomplete information to show that the premises and all equipment in use were maintained safe and fit for purpose.

• Patients’ needs were assessed and care was planned and delivered in line with best practice guidance. Staff had received training appropriate for their roles and any further training needs had been identified and planned.
• Patients spoke very positively about the practice and its staff. They said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available, in different languages and easy to understand for the local population.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. Urgent appointments were available on the same day.
• 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. However they did not have a Patient Participation Group in place.

There were areas of practice where the provider needs to make improvements.

Action the provider MUST take to improve:

• Ensure that staff and patients are protected against risks associated with unsafe premises. This should include implementing a system for identifying, assessing and managing all risks associated with the building.An updated local fire safety risk assessment for the practice should be carried out.

Importantly the provider should;

• Ensure all GPs attend safeguarding and basic life support training

• Ensure that all members of staff who undertake a chaperone role should have a Disclosure and Barring Service (DBS) check completed. If this is not in place a robust risk assessment supporting this decision should be in place.

• Undertake a risk assessment for the need to have oxygen and an AED for use in an emergency. According to current external guidance and national standards this equipment should be in place in all practices.

• Consider setting up a Patient Participation Group (PPG) to provide the practice with real time feedback from patients and the public.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 April 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff were appropriately trained and had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. The practice had a robust recall system in place to ensure patients were reviewed as their needs required. All these patients had a named GP and a structured annual review to check that 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.

Updated 5 April 2016

The practice is rated as good for the care of families, children and young people. Weekly mother and baby clinics for baby and postnatal checks were provided. 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 good 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. For babies and young children up to the age of 5 an appointment to attend was provided at the end of the morning to avoid long waits. Appointments were also available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 5 April 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in 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, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. GPs made schedules visits to local care homes and offered continuity of care with the patients that lived there.

Updated 5 April 2016

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 reflected the needs for this age group. The practice also used the Electronic Prescribing System, increasing convenience for patients who might work during the day.

Updated 5 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia and has a mental health register of patients.  The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 5 April 2016

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. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.