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Billinge Medical Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 10 March 2017

We carried out an announced comprehensive inspection at Billinge Medical Practice on the 25 May 2016. The overall rating for the practice was good. The rating for the key question of safe was requires improvement. The full comprehensive report for the inspection

of 25 May 2016 can be found by selecting the ‘all reports’ link for Billinge Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 16 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 25 May 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

After the comprehensive inspection of 25 May 2016 the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Our key findings were as follows:

  • The practice had addressed the issues identified during the previous inspection.

  • They had provided an up to date electrical certificate for the premises. They have carried out a detailed disability risk assessment.

  • They have displayed their complaints procedure which is accessible to patients and also provided a compliment and suggestion box for their patients.

  • Opening hours for the practice have been updated and displayed in both premises.

  • They have a planned maintenance programme for the premise.

Letter from the Chief Inspector of General 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.

Evidence was provided as part of this desk based review to show that required improvements had been implemented. The practice had an up to date electrical maintenance certificate for the premises. A planned maintenance programme for the premises showed what actions were being taken to refurbish, update and maintain the building.

Effective

Good

Updated 10 March 2017

Caring

Good

Updated 10 March 2017

Responsive

Good

Updated 10 March 2017

Well-led

Good

Updated 10 March 2017

Checks on specific services

People with long term conditions

Good

Updated 10 August 2016

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. Patients who failed to attend appointments were contacted by phone and/or sent reminder letters up to three times before being classified as declining treatment. 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. Indicators for the care of diabetic patients were in line with local and national averages.

Families, children and young people

Good

Updated 10 August 2016

The practice is rated as good for the care of families, children and young people.  The percentage of women aged 25-65 whose notes record that a cervical screening test has been performed in the last five years, was 81% compared to the local clinical commissioning group (CCG) average of 83% and national average of 81%. Appointments were available outside of school hours.  We saw positive examples of joint working with midwives, health visitors and school nurses. The practice had a weekly midwife-led ante-natal clinic. Immunisation rates were in line with local and national averages. GPs offered six weekly baby developmental checks and all baby immunisations on site.

Older people

Good

Updated 10 August 2016

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. Practice nurses visited housebound patients to deliver health care such as annual flu jabs, or to deliver shingles or other immunisations. They also attended the local over 60’s club to administer flu vaccinations and discuss health promotion in a convenient and sociable setting for the patients. The practice had identified those patients at risk of unplanned hospital admission and had agreed care plans in place for these patients. The practice was involved in work to support patients in the ‘Local authority winter warmth scheme.’ The practice provides an in-house anti-coagulation service, the majority being elderly which helps them avoid having to travel to hospital on a regular basis. The practice have completed over 500 health checks on patients over 75 years. The checks encompass all aspects of their health including their medication and social circumstances.

Working age people (including those recently retired and students)

Good

Updated 10 August 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 reflects the needs for this age group. The practice offered early morning appointments from 8.10am and Saturday mornings. Patients are offered telephone consultations for those patients who preferred to call the GP.

People experiencing poor mental health (including people with dementia)

Good

Updated 10 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The percentage of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months was 73%, which was comparable with the national average of 84% and CCG average of 85%. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. They had a register of 74 patients identified 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 did not attend appointments. Staff had a good understanding of how to support patients with mental health needs and dementia. The practice had signed up to be ‘Dementia Friends.’

People whose circumstances may make them vulnerable

Good

Updated 10 August 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 who had special needs such as patients with dementia, learning disabilities and palliative care.  The practice offered longer appointments for patients with a learning disability and annual multi-disciplinary health checks to the 45 patents registered with the practice. 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. The practice lead on safeguarding worked on a regular basis with health visitors and community matrons in order to share information on patients at risk. Practice staff regularly attended local ‘Gold standard framework meetings (GSF).’ They worked closely with the local hospice who had recently been to present talks and updates on the GSF.