Background to this inspection
Updated
23 April 2015
Swan Lane Surgery is situated in Wickford, Essex. The practice is one of 44 GP practices in the Basildon and Thurrock Clinical Commissioning Group (CCG) area. The practice has a general medical services (GMS) contract with the NHS. There are approximately 2900 patients registered at the practice.
There is one full time female GP working at the practice and one part-time female nurse. They are supported by two part-time practice managers and reception staff. The practice uses locum GPs and nurses when the need arises but occasions are rare. It is not a dispensing or a training practice.
The surgery is open each weekday from 8am to 6.30pm and has a late night surgery on a Wednesday until 8pm. They are closed at weekends. The practice has opted out of providing 'out of hours’ services to their own patients so patients contact the emergency 111 service to obtain medical advice outside of normal surgery hours.
Facilities at the practice include parking at the front of the premises. The practice is accessible by public transport.
There has been no information relayed to us that identified any concerns or performance issues for us to consider an inspection. This is therefore a scheduled inspection in line with our national programme of inspecting GP practices.
The CQC intelligent monitoring placed the practice in band two. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.
Updated
23 April 2015
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Swan Lane Surgery on 10 February 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 all of the population groups we looked at.
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.
- Systems were in place to record, monitor and review safety issues. Risks to patients were assessed and well managed.
- 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 the GP or nurse and 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 were areas of practice where the provider needs to make improvements.
Importantly the provider should;
- Provide role specific safeguarding training for staff, including those required to undertake chaperone duties
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
23 April 2015
The practice is rated as good for the care of people with long-term conditions. Patients with chronic illnesses such as diabetes, asthma and chronic obstructive pulmonary disorder were regularly reviewed every six months or annually if their condition was stable. Advice and guidance about their condition was available from qualified clinical staff. Patients at risk were included on a register so their condition could be monitored and a care plan developed to reduce unnecessary hospital admissions. Patients were supplied with antibiotic rescue packs when required. Medicines were reviewed regularly to ensure they were effective and necessary. Patients received flu vaccinations if their conditions made them susceptible to the illness. Longer appointments and home visits were available when needed. All these patients had a named GP. The practice used the Single Point of Referral (SPOR) so that patients could be assessed the same or next day by a district nurse and social worker if they became ill.
Families, children and young people
Updated
23 April 2015
The practice is rated as good for the care of families, children and young people. The practice provided baby and post-natal checks, vaccinations for pregnant women and childhood vaccinations. The GP co-ordinated care for mothers and babies with the local hospital maternity services. The practice had a ‘looked after children’ register for vulnerable children and these were monitored regularly involving other healthcare professionals. Staff had been trained in safeguarding procedures for children. Children and young people were treated in an age-appropriate way and were recognised as individuals. Staff were aware of the Gillick competence test if children wished to see a GP or nurse without a parent or guardian being present. Regular liaison with the local health visitor and school nurse took place who attended multidisciplinary meetings to discuss families in need of additional support. Immunisation rates were high for all standard childhood immunisations.
Updated
23 April 2015
The practice is rated as good for the care of older people. They were aware of their elderly patient population and each patient had a named GP. 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. It was responsive to the needs of older people, and offered emergency appointments, home visits and telephone consultations for those who required them. The practice offered senior health checks for the elderly and a vaccination service was available for the prevention of flu, pneumococcal illnesses and shingles. The practice participated in the Direct Enhanced Service Admission Avoidance service to monitor elderly patients at risk of admission to hospital. This involved multidisciplinary meetings where individual patients care and treatment was discussed to identify a treatment plan to maintain their health. The practice was also in the process of setting up a ‘virtual ward’ with other healthcare professionals to enhance the care of their patients to avoid hospital admissions.
Working age people (including those recently retired and students)
Updated
23 April 2015
The practice is rated as good for the care of working-age people (including those recently retired and students). The practice was aware of the needs of the working age population, those recently retired and students. These 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 a wide range of appointments from 8.40am to 6.20pm Monday to Friday, with extended hours until 8pm on Wednesdays. Health checks for those aged between 40 and 74 were available through the appointment system or at a dedicated clinic.University students could be registered as temporary patients when they returned home during their holiday.
People experiencing poor mental health (including people with dementia)
Updated
23 April 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). They were aware of the numbers of patients in this group and their healthcare needs. All had received regular health checks and reviews of their medicines. Longer appointments were given to patients to help understand their condition and to provide the appropriate advice. Referrals to specialists were made in the more complex cases. Patients were signposted to external organisations that could provide additional support. A mental health counsellor from an organisation known as ‘Therapy for You’ attended the practice to provide support for patients suffering with depression. Clinical staff had received training in mental health capacity assessments and deprivation of liberty safeguards in line with the Mental Capacity Act 2005. Patients with memory impairment were referred to a memory clinic for early diagnosis and treatment if indicated. Patients with dementia had an annual health review undertaken by their GP or by the community dementia nurse. The practice liaised with the local dementia crisis team so that patients could be treated effectively and remain in their home as long as possible.
People whose circumstances may make them vulnerable
Updated
23 April 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 with a learning disability and this was monitored to ensure they received an annual health check and follow-up with a GP if required. Longer appointments for people with a learning disability were available if required. The practice supported homeless people who were vulnerable, with health checks and support with external agencies. Counselling and support was available for patients with alcohol addiction by practice staff. Members of the travelling community received consultations, care and advice related to their medical needs.