Archived: Abbey Manor Medical Practice

Updated 27 August 2015

We inspected the location of Abbey Manor Medical Practice, The Forum, Abbey Manor Park, Yeovil, Somerset, BA21 3TL, where all the registered regulated activities were carried out. Hendford Lodge Medical Practice was also run by the same partnership as Abbey Manor Medical Practice under the Diamond Health Group. This location is registered separately and was not inspected as part of this inspection.

The practice serves approximately 2850 patients who live in Yeovil and the surrounding areas. The national general practice profile shows the practice has a higher than England average population of female patients from birth to 9 years old, 25 to 39 years and 85 years and over. The male patient population was higher than average from birth to 14 years and 20 years to 24 years old. The practice has below the national and local average for females between 75 to 84 years and male and females from 55 to 69 years old. The practice sited in one of the least deprived areas in their patient catchment area.

There were 10 GPs within the partnership who run the two practices Abbey Manor Medical Practice and Hendford Lodge Medical Centre under the name of Diamond Health Group. At Abbey Manor Medical Practice two of the 10 GP partners are based at this practice to provide continuity of care to patients. There was one male and one female GP. The GPs worked the equivalent of 1.25 full time hours with one GP working one a day week and the other working four days a week. Other GPs in the partnership cover any absences, such as annual leave or training days, to avoid using locum cover and to provide continuity of care.

The nursing team also worked in both medical practices. A nursing manager oversees the nursing team within both practices and provides patient care. There were six practice nurses employed over both locations with two practice nurses providing the main nursing care at Abbey Manor Medical Practice. There were also five healthcare assistants employed over both locations with two of these providing the majority of health care assistant at Abbey Manor Medical Practice.

The practice has a Personal Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice). The practice is contracted for a number of enhanced services including extended hours access, facilitating timely diagnosis and support for patients with dementia, minor surgery, patient participation, immunisations and remote care monitoring. The practice refers their patients to NHS 111 operated by South Western Ambulance Service for out-of-hours services to deal with urgent needs when the practice is closed. The service provider is due to change as of 1 July to Somerset Doctors Urgent Care, operated by Vocare.

Additional services are provided from the practice premises including South Somerset Leg Ulcer Service and OASIS East orthopaedic interface clinic. Patients can also access weekly appointments with a dietician within the practice.

The practice has patients registered at one nursing home.

Updated 27 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Abbey Manor Medical Practice on 24 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 there were areas of practice where the provider needs to make improvements.

Importantly the provider should;

• Ensure there is an effective monitoring system in place to monitor staff training including information of what is expected of staff to complete on a mandatory basis and how often.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 August 2015

The practice is rated as good for the care of patients 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. Longer appointments and home visits were available when needed. 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 patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

A diabetes information evening was held in September 2014 which was attended by GPs, nurses and a small group of patients. Patients were able to share their experiences with others including those who had been diagnosed recently.

Updated 27 August 2015

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

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 relatively high or average for standard childhood immunisations. Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals. Appointments were 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 27 August 2015

The practice is rated as good for the care of older patients.

The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in facilitating the timely diagnosis and support for patients with dementia. They were responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs including those residing in nursing homes.

Updated 27 August 2015

The practice is rated as good for the care of working-age patients (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.

Updated 27 August 2015

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

We saw 65% of patients experiencing poor mental health had received an annual physical health check in the last year. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations. They had a system in place to follow up patients who had attended accident and emergency (A&E) when they may have been experiencing poor mental health.

Updated 27 August 2015

The practice is rated as good for the care of patients 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 had 12 patients registered with a learning disability and they had carried out 60% of annual health checks for patients with a learning disability in the last year.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. They 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.