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Birchwood Medical Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Birchwood Medical Practice on 3 February 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • 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.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 March 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events
  • Lessons were shared to make sure action was taken to improve safety in the practice.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 17 March 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were at or above average for the locality and compared to the national average.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 17 March 2016

The practice is rated as good for providing caring services.

  • Data from the National GP Patient Survey showed patients generally rated the practice in line with local averages for several aspects of care.

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

  • Information for patients about the services available was easy to understand and accessible.

  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 17 March 2016

The practice is rated as good for providing responsive services.

  • The practice were aware of the needs of its local population and engaged with the Clinical Commissioning Group to secure improvements to services where these were identified.

  • Patients said they found it easy to make an appointment with a named GP and 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.

  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 17 March 2016

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to this.

  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.

  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

  • The provider was aware of and complied with the requirements of the Duty of Candour. The partners encouraged a culture of openness and honesty.

  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

  • There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions

Good

Updated 17 March 2016

The practice is rated as good for the care of people with long term conditions.

  • Nursing staff were well qualified in chronic disease management and there was a lead for each chronic disease.

  • 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.

  • Effective recall procedures in place for disease monitoring with annual (on birthday) reviews and electronic prescribing and online ordering.

  • Practice nurses available during extended hours to facilitate ease of access for chronic disease reviews

  • Management of leg ulcers and dressings

  • Year round immunisation services with additional clinics during flu season

  • All day in-house and domiciliary phlebotomy service

Families, children and young people

Good

Updated 17 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. 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 positive examples of joint working with midwives, health visitors and school nurses.

  • Twice weekly midwife clinic

  • Daily 'open' children’s’ GP surgery

  • Sexual health & contraception clinic including chlamydia screening, IUD, IUS, implant, C-Card scheme

  • Toy tables in each consulting/treatment room and waiting room.

Older people

Good

Updated 17 March 2016

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

  • Care plans were in place and updated through monthly multi-disciplinary meetings with District Nurses for patients on the ‘at risk’ and palliative care register. Urgent telephone access was available to the named GP.

    The practice worked other agencies such as Macmillan and Complex Care nurses, the local Neighbourhood Team, the Primary Care Navigator, and the Independent Living Team to create individualised care plans that respected patient’s wishes.

  • .Weekly visits undertaken and urgent telephone access to Care Homes by their responsible GP.

  • A leg ulcer service

  • Practice Nurse & HCA home visits by a practice nurse or HCA were available.

Dementia Friendly through training.

Working age people (including those recently retired and students)

Good

Updated 17 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

  • Out of Area registrations

  • Same day urgent triage

  • Telephone consultations

  • In house phlebotomy service

  • Extended hours – early morning & evening appointments with GP, nurse or HCA

  • Men's Health Appointments

  • NHS health checks

  • In house physiotherapy & podiatry service

  • Travel clinic - advice and vaccination

  • Nurses trained in smoking cessation

  • Referral to weight watchers and exercise referrals

  • Minor surgery facilities

People experiencing poor mental health (including people with dementia)

Good

Updated 17 March 2016

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

  • Mental health care plans and annual reviews

  • Contact with Mental Health Liaison Nurse

  • Regular contact with Community Psychiatric Nurse

  • In house memory clinic

  • Signposting and referral to appropriate support agencies

  • Same day urgent triage

  • Opportunistic dementia screening for at risk patients

  • Dementia aware and Dementia Friendly staff

  • Carer support & signposting

People whose circumstances may make them vulnerable

Good

Updated 17 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

  • The practice list was open to all patients including the homeless.

  • There was a learning disability lead within the practice and annual health checks for patients with learning disability. Flexible appointments were available for this group of patients.

  • The practice regularly worked with multi-disciplinary teams such as health visitor, social services and the neighbourhood team in the case management of vulnerable people.

  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations such as food banks and citizens advice bureau.

  • Staff gave examples which illustrated they 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.

  • Translation services were available which included on the check in screen and practice website.