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Hereford Medical Group Good Also known as HMG

Inspection Summary


Overall summary & rating

Good

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 15 October 2014.

The practice has a main surgery and two branch surgeries. We did not include the branch surgeries in this inspection.

We have rated this practice as ‘good’ overall. We found the practice to be ‘good’ in the safe domain, the effective, caring, responsive and well-led domains. We found the practice provided good care to older people; people with long term conditions; families, children and young people; the working age population and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

  • The practice had clear and thorough systems to monitor safety. They ensured that any information arising from complaints or significant events was shared so that staff could learn them and improve the service for patients.

  • The systems in place at the practice to manage medicines and to ensure infection control were clear, robust and thorough.

  • Patients were positive about the care and treatment they received.

  • The practice team understood the needs of their patient population. They offered appointments at times which were convenient to patients and they worked flexibly as a team to ensure patients’ health needs were met.

  • The practice had created a ‘learning culture’ which involved all members of the practice team and ensured that patients continually benefitted from high levels of care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 19 February 2015

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were enough staff to keep people safe.

Effective

Good

Updated 19 February 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were at or above average for the locality. Staff referred to guidance from the National Institute for Health and Care Excellence (NICE) and used it routinely. People’s needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training appropriate to their roles and any further training needs had been identified and planned for. The practice could identify all appraisals and the personal development plans for all staff. Staff worked with multidisciplinary teams.

Caring

Good

Updated 19 February 2015

The practice is rated as good for providing caring services. Data showed that patients rated the practice higher than others 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 to help patients understand the services available was easy to understand. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

Responsive

Good

Updated 19 February 2015

The practice is rated as good for providing responsive services. It reviewed the needs of its local population and engaged with the NHS Area Team and Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. Patients said they could make an appointment with a named GP and that when they needed urgent care, same day appointments were available.

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 that the practice responded quickly to issues raised. There was clear evidence that all staff discussed complaints and learned from them.

Well-led

Good

Updated 19 February 2015

The practice is rated as good for being well-led. It had a clear vision and strategy. 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 were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group (PPG) was active. Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

People with long term conditions

Good

Updated 19 February 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when patients needed them. All these 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.

Families, children and young people

Good

Updated 19 February 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. 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. There were good examples of joint working with health visitors. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Older people

Good

Updated 19 February 2015

The practice is rated as good for the care of older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and provided a range of 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 complex needs.

Working age people (including those recently retired and students)

Good

Updated 19 February 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..

People experiencing poor mental health (including people with dementia)

Good

Updated 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health, including people with dementia. The practice regularly worked with multi-disciplinary teams to support patients experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia and provided appropriate information for them or referred them to other teams. The GPs referred to themselves as ‘advocates’ for their most vulnerable patients.

People whose circumstances may make them vulnerable

Good

Updated 19 February 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 who needed end of life care and offered these patients a caring and compassionate service. The practice held a register of patients with a learning disability. It had set up systems for carrying out annual health checks for this group and was about to start these checks.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It provided information 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.