Archived: Beddington Medical Centre

Updated 28 May 2015

Beddington Medical Centre is located in Sutton, Surrey. It operates from converted premises which consist of a ground floor comprising the reception and waiting areas, treatment and consultation rooms. The upper floor of the premises has further consultation rooms and designated staff offices.

At the time of our inspection, there were 3682 registered patients in the practice.

The practice had a personal medical services (PMS) contract for the provision of its general practice services.

The practice staff team were two GPs, both male, one female practice nurse and regular locum practice nurse, a practice manager, an IT administrator and a team of four reception staff.

Beddington Medical Centre is registered with the Care Quality Commission (CQC) to carry on the regulated activities of Diagnostic and Screening procedures, Family planning services, Maternity and midwifery services, Treatment of disease, disorder or injury to everyone in the population.

The practice had opted out of providing out-of-hours services to their patients. Patients were directed to contact the national free-to-call medical helpline, 111, when the practice was closed.

Updated 28 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Beddington Medical Centre on 15 January 2015. Overall the practice is rated as good.

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

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, including those relating to recruitment, medicines management and infection control.
• 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 was an area of practice where the provider needs to make improvements.

Importantly, the provider must :

• clarify its policies in relation to Disclosure and Baring Service (DBS) checks, and include these in its recruitment policy.
• ensure DBS checks are undertaken for all staff who undertake chaperone duties at the practice.

In addition, the provider should

• Ensure an automated external defibrillator (AED) is available, or have on record a risk assessment if a decision is made to not have an AED on-site.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

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.

There were weekly asthma and chronic obstructive pulmonary disease (COPD) clinics in the practice, run by a practice nurse.

One of the principal GP was able to provide minor surgical procedures, the form of joint injections. We saw that appropriate records were completed for these procedures, and suitable entries made on the patients’ notes.

Longer appointments and home visits were available when needed.

Government guidelines recommend that flu vaccinations are offered to certain at risk groups so that they are protected from the illness and developing serious complications. Patients with long term conditions were offered seasonal flu vaccinations in response to these recommendations.

All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. We saw evidence that care plans were appropriately completed with patients with particular needs. We also saw that when there were changes to patients’ circumstances, these care plans were reviewed and amended as required, for example following a hospital admission. Alerts were put on patients’ notes if they had a care plan in place. This alerted the reception staff when the patient called for appointments, so they may be prioritised for appointments.

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. Multidisciplinary meetings were held to discuss the patients’ needs and these were well documented.

Updated 28 May 2015

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, or who did not attend fore recommended appointments such as childhood vaccinations.

Pregnant women were offered health information booklets and referred on to appropriate community based healthcare services.

The practice GPs carried out eight week post natal check for new mothers, and 6 week baby checks in line with government guidelines.

Immunisation rates were relatively high for all standard childhood immunisations.

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 and health visitors.

Updated 28 May 2015

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.

All patients over the age of 75 had a named GP.

Regular medicines reviews were completed with all patients. Letters inviting patients to these reviews were sent out with the repeat prescriptions.

Patients with mobility needs could be seen in a consultation room on the ground level of the practice premises.

All patients over the age of 65 were offered a flu vaccination in line with government recommendations. At the time of our inspection the practice had vaccinated 73.3% of its patients in this group, which was similar to the national average. The practice also offered shingles vaccines and pneumococcal vaccines.

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 28 May 2015

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 28 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). For the 2013 / 14 year, the QOF data showed that 95.8% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive care plan documented in their record, in the preceding 12 months, agreed between the individuals concerned, their family and/or carers as appropriate.

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 GPs were aware of the Mental Capacity Act 2005 and their duties in fulfilling it. All the clinical staff we spoke with understood the key parts of the legislation and were able to describe how they implemented it in the practice.

Patients with poor mental health had their records coded accordingly. This meant that this information was flagged up to reception staff when they called for appointments, and prompted them to offer these patients additional support such as longer appointments.

Updated 28 May 2015

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 and those with a learning disability. It had carried out annual health checks and 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.

The practice GPs carried out the health checks, as required under the directed enhanced service (DES) that was in addition to their contract, for patients with learning disabilities. All the residents (eight in total) in a local care home for people with learning disabilities were registered patients at the practice. The practice manager gave us an example of how they had worked with local providers, in this case the phlebotomy service at the local hospital, to provide them with recommended tests.

The practice reception team organised transport for vulnerable patients who made the request, such as those with mobility needs.

Home visits were available for housebound patients.