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Archway NHS Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 1 May 2018

At the previous inspection, in January 2016, we had rated the Archway Medical Centre as Good. We carried out this further comprehensive inspection on 22 February 2018, in accordance with our published process to re-inspect a proportion of practices previously rated as good or outstanding. We have again rated the practice as Good overall and in relation to the five key questions:

Are services safe? - Good

Are services effective? - Good

Are services caring? - Good

Are services responsive? - Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups, which we have rated as follows:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

At this inspection we found:

  • The practice learned from incidents and took action to improve its processes.
  • Published data showed the practice performance was comparable with local and national averages.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence-based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found it easy to use the appointment system and told us they could access care when they needed it. However, waiting times with appointments running late, were above average.
  • Data from the GP patient survey showed that patient satisfaction was generally above local and national averages. Where a need for improvement had been noted, the practice had drawn up action plans.

The areas where the practice should make improvements are:

  • Continue to monitor appointments running late and identify how delays can be reduced.
  • Continue with efforts to improve the uptake rates of childhood immunisations.
  • Continue with efforts to identify and support patients who are carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice


Inspection areas

Safe

Good

Updated 1 May 2018

Effective

Good

Updated 1 May 2018

Caring

Good

Updated 1 May 2018

Responsive

Good

Updated 1 May 2018

Well-led

Good

Updated 1 May 2018

Checks on specific services

People with long term conditions

Good

Updated 15 March 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.

  • The practice maintained a register of 282 patients with diabetes, of whom 192 had received an annual eye (retinal) check. Eighty per cent of patients on the diabetes register had received flu vaccinations; 81% had had an annual foot check and 82% been given a structured education programme, to help them manage their health condition.

  • Longer appointments and home visits were available when needed.

  • The practice used its electronic records system to identify patients at high risk of developing long term conditions and to manage their health care.

  • Flu vaccination rates for patients at high risk were 12% above the national average.

Families, children and young people

Good

Updated 15 March 2016

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

  • 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.

  • 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’s cervical screening rate was comparable with the national average.

  • Appointments were available outside of school hours.

  • We saw good examples of joint working with midwives, health visitors and school nurses.

  • Immunisation rates for the standard childhood immunisations were high, compared with the local average.

Older people

Good

Updated 15 March 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 maintained a case management register of 139 patients considered to be at high risk of admission to hospital, all of whom 121 (81%) had had their care plans reviewed and shared with relevant parties at the time of our inspection.

  • We saw evidence that patients discharged from hospital received a follow up consultation.

  • Two hundred and eleven patients identified as at risk of developing dementia had been offered cognition tests.

  • It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

  • All patients aged over 75 had a named GP.

  • The practice provided a service to two large local care homes, with GPs attending weekly “ward rounds”.

  • Flu vaccination rates for patients aged over 65 were 11% above the national average.

Working age people (including those recently retired and students)

Good

Updated 15 March 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 had carried out blood pressure tests on 1,587 patients aged over 45, being 90% of those eligible.

People experiencing poor mental health (including people with dementia)

Good

Updated 15 March 2016

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

  • The practice maintained a register of 63 patients with dementia, of whom 42 (70%) had had their care reviewed in a face to face meeting in the last 12 months.

  • 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 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 where they may have been experiencing poor mental health.

  • Staff had a good understanding of how to support people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 15 March 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.

  • There were twice-monthly sessions with an alcohol worker offering patients specialist advice.

  • There were twice-weekly sessions with a Citizens’ Advice Bureau worker, to provide advice regarding benefits and housing issues.

  • 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.