Background to this inspection
Updated
16 August 2016
Jenner House Surgery is based at 159 Cove Road, Farnborough, Hampshire, GU14 0HQ. The practice provides a service to approximately 10,000 patients and has recently closed its patient list. The practice has two GP partners, one of whom who will shortly be leaving. The practice uses GP locums to fill the current GP vacancies. The GPs are supported by a team of practice nurses, advanced nurse practitioners, a physiotherapist (as part of a local pilot scheme) and a phlebotomist. There is also a practice manager and a team of reception and administrative staff.
The practice offers approximately 40 GP sessions per week. Patient appointments are available between 8.30am and 6.30pm daily. Extended hours appointments are available on Mondays until 8.30pm. Appointments are also available to pre-book on Saturday mornings between 9am and 11am. When the practice is closed, patients are able to access urgent care via the NHS 111 service.
Updated
16 August 2016
Letter from the Chief Inspector of General Practice
We carried out a follow up review of Jenner House Surgery on 28 July 2016 to check that action had been taken since our previous inspection in October 2014. Overall the practice is rated as good.
At our inspection in September 2014 we rated the practice as good overall. The practice was good for Effective, Caring, Responsive and Well-Led services.
However, we found that the practice required improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services. We found that the registered person did not ensure that recruitment checks were fully completed for locum GPs working at the practice, specifically to check references from previous employers.
We revisited Jenner House Surgery to have a look at the personnel files for locum GPs that have been used by the practice since the date of the last inspection.
We undertook this focused follow up inspection on 28 July 2016 to check that they had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link from Jenner House Surgery on our website at www.cqc.org.uk
Our key findings for this review were as follows:
- Written references were now obtained from previous employers for any GP working at Jenner House Surgery.
The practice is now rated good for Safe services and remains rated good overall.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
5 March 2015
The practice is rated as
good for the population group of people with long term conditions.
Emergency processes were
in place for patients in this group that had a sudden deterioration in health
and required referrals.
When needed longer
appointments and home visits were available. All these patients had a named GP
and structured annual reviews 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.
Families, children and young people
Updated
5 March 2015
The practice is rated as
good for the population group of families, children and young people The
practice approached safeguarding arrangements for children to ensure that
children at risk and children who may be at risk of harm were known about and
safeguarded.
In addition,
regular
meetings were held to discuss relevant children and families with the health
visitor and the GPs were fully involved with child protection planning and
meetings.
The practice also met
the needs of families, children and young people by having specific services to
meet these needs. The practice actively sought to meet childhood immunisation
targets and followed up on the health of babies through post-natal checks.
The appointment system
ensured young children were seen on the same day as they presented.
The practice had
safeguarding children policies and procedures in place. We found there were
appropriate systems in place to respond to any concerns. The practice nurses
regularly met with the health visitors to ensure they offered the care and
treatment families with babies and young children needed.
The practice had a range
of child health clinics and these were promoted by posters and through the
practices website. In addition, families, babies, children and young people had
a named GP to promote the continuity of their care.
Updated
5 March 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 by operating a
personalised GP patient list, and by ensuring that patients over the age of 75
saw their own GP wherever possible.
The practice was
responsive to the needs of older people, including offering home visits and
rapid access appointments for those with enhanced needs.
The practice had systems
in place to ensure patients end of life care and treatment wishes were known
and respected.
All the GPs we spoke with told us about how they
supported patients, and how they shared information within the practice. Essential
information was shared with external agencies to ensure patient’s end of life
wishes were known and adhered to.
We reviewed the
practice's policies and procedures on safeguarding vulnerable adults. We found
there were appropriate systems in place to respond to any concerns
relating to older patients. GPs described situations where they had reported a concern to the lead safeguarding
agency and told us about how this had safeguarded vulnerable adults.
Working age people (including those recently retired and students)
Updated
5 March 2015
The practice is rated as
good for the working-age people (including those recently retired and students).
The practice had a high
population of patients who were either working age or recently retired but the
services available did not fully reflect the needs of this group. Although the
practice offered extended opening hours for appointments during Monday to
Friday, there was no online appointment booking or on-line repeat
prescribing system in place, although patients could request repeat
prescriptions by post, email, fax or in person.
People experiencing poor mental health (including people with dementia)
Updated
5 March 2015
The practice is rated as
good for the population group 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. The
practice had in place advance care planning for patients with dementia.
Staff gave examples of how they responded to
patients experiencing a mental health crisis, including supporting them to
access emergency care and treatment.
The system of personalised GP lists enabled patients
who were experiencing poor mental health to receive continuity of care and
build up a relationship with their named GP. GPs told us about how they
sign-posted patients to community services, including a local drop in café.
The practice had accessible appointments and
patients who felt anxious about waiting in the reception area could enter the
practice though another door and wait in a quiet separate room.
People whose circumstances may make them vulnerable
Updated
5 March 2015
The practice is rated as
good however there are aspects that require improvement for the population
group of people whose circumstances may make them vulnerable.
The practice had a
significant number of patients whose first language was not English. The
practice told us they relied on patients attending appointments with family
members who could act as interpreters. There was limited written information
available for these patients in an alternative language.
The practice held a
register of patients living in vulnerable circumstances including those with
learning disabilities. The practice had carried out annual health checks for
people with learning disabilities, and these patients had a nominated GP to
ensure they received continuity of care from a GP they knew and felt
comfortable with. However there was no information available for these patients
in an accessible format such as easy read or pictorial formats.
The practice worked with
multi-disciplinary teams in the case management of vulnerable people. The practice
had sign-posted vulnerable patients to various support groups and voluntary organisations.
Patients without a permanent address could register using the practice address
and staff told us that vulnerable patients could be seen on the same day as registering
if their need was urgent.
Staff knew how to
recognise signs of abuse in vulnerable adults and children and were aware of
their responsibilities regarding information sharing, documentation of
safeguarding concerns and how to contact relevant agencies in and when the
practice was closed.