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Haslemere Health Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 17 August 2021

We carried out an announced focused review at Haslemere Health Centre on 17 June 2021. The practice was not rated as a result of this review.

The practice had previously been inspection on 9 March 2016, and had been rated Good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Haslemere Health Centre on our website at www.cqc.org.uk

Why we carried out this review

This review was a focused review of information held at the practice without undertaking a site visit. This was to follow up on specific concerns that had been raised about the practices’ prescribing of benzodiazepines to patients who were living in a care home.

How we carried out the review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our reviews differently.

This review was carried out in a way which enabled us to work remotely without a site visit. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify any issues and clarify actions taken by the provider

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We found that:

  • The records reviewed for patients in a care home setting prescribed bensodiazepines showed that the practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • The practice adjusted how it delivered services to meet the needs of patients, including who were resident in care homes, during the COVID-19 pandemic.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection areas

Safe

Good

Effective

Good

Caring

Good

Responsive

Good

Well-led

Good
Checks on specific services

People with long term conditions

Good

Updated 10 May 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.
  • 76% of patients on the diabetes register had their last blood pressure reading (measured in the preceding 12 months) as 140/80 mmHg or less, which is comparable with the national average of 78%.
  • 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. 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.

Families, children and young people

Good

Updated 10 May 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.
  • 72% of patients with asthma, on the register, had an asthma review in the preceding 12 months compared to a national average of 75%.
  • 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.
  • 78% of eligible female patients had a cervical screening test which was slightly below the national average of 82%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • We saw positive examples of joint working with midwives and health visitors.
  • The practice offered a daily minor ailments clinic which allowed patients to access on the day treatment for minor infections and other minor ailments.

Older people

Outstanding

Updated 10 May 2016

The practice is rated as outstanding 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 identified those patients most at risk of hospital admissions and created proactive care plans. They employed a care coordinator to ensure these care plans were kept up to date and were shared with the ambulance service, GP out of hours and the hospital. This had reduced the ambulance conveyance rate for at risk patients to 42% compared to a national average of 65%.
  • The practice kept a register of frail elderly patients and discussed these patients weekly with the community matron to avoid hospital admission where possible.
  • The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. The appointment system had been designed to give continuity with a preferred GP for patients with complex needs.
  • The practice carried out weekly visits at two care homes for older people and feedback from the homes was positive.
  • The practice provided medical cover at the local community hospital carrying out daily ward rounds, including at weekends. This gave patients continuity of care and the chance to rehabilitate near their home area.
  • The practice provided pulse checks at the annual flu clinics and as a result identified 2.1% of their population as having atrial fibrillation, against a national average of 1.6%. 
  • The practice had established a joint clinic with the practice nurse and vascular consultant allowing prompt and expert assessment of patients at potential risk of joint amputation. This early prioritisation had identified three patients who were at risk of significant loss of limb.

Working age people (including those recently retired and students)

Good

Updated 10 May 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 offered early morning appointments from 7am three times a week and late evening appointments until 8pm twice a week.

  • A Health Care Assistant offered well person health checks during the day and evening, and a bespoke printout was given to each patient to inform them of their results and actions required.

  • 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 actively worked with a pharmacy chain to bring a pharmacy with long opening hours to the building providing convenient access to patients.

People experiencing poor mental health (including people with dementia)

Good

Updated 10 May 2016

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

  • 74% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is below the national average of 84%.
  • 92% of patients experiencing poor mental health had an agreed care plan, which is better than the national average of 88%.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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 had attended accident and emergency where they may have been experiencing poor mental health.
  • Staff had a good understanding of how to support patients with mental health needs and dementia.
  • The practice had worked with dementia specialists to review dementia diagnosis levels and the support required for patients with dementia and mild cognitive impairment.

People whose circumstances may make them vulnerable

Good

Updated 10 May 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 patients, travellers and those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. The practice sits on the boundary of three counties and had to work hard to coordinate care with district nurses and social services across the different counties.
  • 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 in normal working hours and out of hours.
  • Educational sessions for doctors and nurses had been held on the treatment of addiction and assessing suicide risks.