Archived: Hobmoor Road Surgery

Updated 20 September 2016

• Hobmoor Road Surgery is located in Yardley, an area in the east of Birmingham, in the West Midlands. Hobmoor Road Surgery currently provides services to 3005 registered patients and has a higher than national average percentage of patients aged five to eighteen years of age.
• The practice has a General Medical Services (GMS) contract. The GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.
• The practice has one principal GP (male), one salaried GP (male), one locum GP (male), two health care assistants, a practice nurse, two practice managers, an assistant practice manager and three administrative/reception staff.
• The practice is open for appointments on a Monday, Tuesday, Wednesday and Friday from 8.30am to 6.30pm and on a Thursday 8.30am to 1pm each week. In addition to pre-bookable appointments that can be booked up to two weeks in advance, urgent appointments are also available for patients that need them.
• The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. The practice employs the use of the Birmingham and District General Practitioner Emergency Room group (Badger) to provide this out-of-hours service to patients.

This focused inspection was to review the action taken by the provider to meet regulatory requirements where we had previously identified breaches of the regulations and where they should improve in other areas. For this reason we have only rated the location for the safe domain to which the regulations relate. The report should therefore be read in conjunction with both the full comprehensive inspection report published on 21 January 2016 and the subsequent focussed report published on 19 May 2016.

Updated 20 September 2016

Letter from the Chief Inspector of General Practice

On 21 January 2016 we carried out a comprehensive inspection at Hobmoor Road Surgery. The practice was rated as good overall, but requires improvement under the safe domain. As a result of that inspection we found that improvements were required so we issued the practice with a requirement notice for improvement.

We then conducted a focused inspection of the practice on 8 April 2016 to check whether the improvements had been made. At this inspection we found that the improvements identified at the January inspection had been actioned. However we found some new concerns.

The concerns related to recruitment processes and staff who acted as chaperones who had not received a Disclosure and Barring Service check (DBS check) nor in its absence had a risk assessment been carried out to make sure patients were protected. As a result the practice was issued with two new requirement notices for breaches of regulation 17 (Good governance) and regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This meant that the practice continued to be rated as requires improvement for the safe domain.

We also found a number of areas where the practice should make improvements that were not specific breaches of the regulations. These included infection control processes and ensuring that the safeguarding policy was updated to reflect current practice and disseminated to all staff.

We then carried out a focused inspection at the practice on 1 September 2016 to review the action taken by the provider to meet the regulatory requirements where we had identified breaches of the regulations and other areas where they should take action. The report should therefore be read in conjunction with both the full comprehensive inspection report published on 21 January 2016 and the subsequent focussed report published on 19 May 2016.

At this inspection we found the practice had made changes since their previous focused inspection. We found that sufficient action had been taken regarding the issues identified and the practice was now meeting the requirements of the breaches identified. This meant that the practice was now rated as good in safe domain. All other domains were previously rated as good.

Specifically we found that since the last inspection:

• The practice had ensured the recruitment policy was being properly implemented to ensure that all necessary employment checks were taking place for all staff.
• All staff, including those who acted as chaperones had now undergone the appropriate checks through the DBS.
• The practice had reviewed and updated the safeguarding policy and disseminated to all staff. Post-inspection, one of the GPs completed safeguarding training to an appropriate level and provided us with evidence of this.
• Previously we found that practice processes for completing and monitoring required infection control and prevention actions were not in place. At this inspection the practice told us the actions had been completed and post-inspection we were provided with evidence to demonstrate this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 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. Longer appointments and home visits were available when needed. All 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 21 January 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. Immunisation rates were relatively high 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. 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 21 January 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.

Updated 21 January 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.

Updated 21 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 100% of people experiencing poor mental health had received an annual physical health check. 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.

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. Staff had received training on how to care for people with mental health needs and dementia.

Updated 21 January 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 had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. 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.