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Archived: Dr Klemenz Good Also known as Northern Road Surgery

Inspection Summary


Overall summary & rating

Good

Updated 21 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Klemenz and Partners on 7 January 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services to older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health. It required improvement for providing safe services.

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, with the exception of those relating to Legionella.

• 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.

• 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 also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Review access to the repeat prescribing system and how it is used.
  • The practice must ensure prescription pads which are completed by hand are stored securely and auditable records are kept.

In addition the provider should:

  • Review how they manage expiry dates which change when medicines are stored at different temperatures.
  • The practice should consider keeping records of how they responded to alerts including medicine recalls.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Requires improvement

Updated 21 May 2015

The practice is rated as requires improvement for providing safe services as there are areas where improvements should be made.

Systems were in place for reporting, recording and monitoring significant events. Infection prevention and control systems were in place and regular audits were carried out to ensure that all areas were clean and hygienic.

Appropriate checks were made on all staff before they started to work. Staff files were comprehensive and complete.

Arrangements relating to the availability of safe and secure storage of medicines and vaccinations was not effective. We saw that safety features within the repeat prescribing system including “review dates” and “percentage medicines use” were not used consistently. We also observed that the computer access levels granted to reception staff allowed them to change prescribing parameters. Therefore, we were not assured that patient’s repeat prescriptions were still appropriate and necessary.

Effective

Good

Updated 21 May 2015

The practice is rated as good for providing effective services.

Data showed patient outcomes were at or above average for the locality. National Institute for Health and Care Excellence guidance was referenced and used routinely. Multidisciplinary working was also evidenced. Patients’ needs were assessed and care planned and delivered in line with current legislation which included assessments of a patient’s mental capacity. Staff were proactive in promoting good health and referrals were made to other agencies to ensure patients received the treatment they needed in a timely manner. Staff had annual appraisals and told us that their training needs were supported by senior staff.

Caring

Good

Updated 21 May 2015

The practice is rated as good for caring.

Patients told us that they were well informed about their care and treatment. We observed patients being treated with dignity and respect. Staff provided privacy during all consultations and reception staff maintained patient privacy, dignity and confidentiality when registering or booking in patients.

All the patients we spoke with, and the comments we received were complimentary of the care and service staff provided.

Responsive

Good

Updated 21 May 2015

The practice is rated as good for responsive.

The practice understood the needs of their patient population and this was reflected in the practice environment and systems used to meet some of the needs of their patients.

Patients told us they could always get an emergency appointment the same day and waiting time for routine appointments was satisfactory.

The practice obtained and acted on patients’ feedback. The practice learned from patient experiences, concerns and complaints to improve the quality of care.

Well-led

Good

Updated 21 May 2015

The practice is rated as good for well-led.

There was a clear leadership structure and staff felt supported by management and a culture of openness and honesty was encouraged.

The staff worked as a team and ensured that patients received a high standard of care. Staff had received induction, regular performance reviews and attended staff meetings.

Risks to the safe and effective delivery of services were assessed and addressed in a timely manner. A suitable business continuity plan was in place. The practice had a number of policies and procedures to govern activity and regular governance meeting had taken place.

The practice proactively sought feedback from staff and patients and this had been acted upon. The practice had an active patient participation group.

Checks on specific services

Older people

Good

Updated 21 May 2015

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

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. 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. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with greater needs. The practice cared for 20 patients living in four care homes for older people in their catchment area.

The practice also interacted with the voluntary sector, community geriatrics and older mental health services.

People with long term conditions

Good

Updated 21 May 2015

The practice is rated as good for people with long-term conditions.

The practice had a good system for surveillance of long term conditions and maintained an up to date register. Regular practice meetings were held to plan and review actions and to alert and update team members. The practice had 90 patients on the long term conditions list. This was approximately two per cent of the practice list.

Patients in this population group received safe, effective care which was based on national guidance. Care was tailored to patient needs, there was a multi-disciplinary input and was reviewed regularly.

The practice provided regular clinics for patients with diabetes, respiratory and cardiac conditions

Families, children and young people

Good

Updated 21 May 2015

The practice is rated as good for the population group of families, children and young people.

The practice followed national protocols and staff were aware of their responsibilities and the various legal requirements in the delivery of care to people in this population group. They worked with other health and social care providers to provide safe care.

Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an appropriate way and recognised as individuals. We were provided with good examples of joint working with midwives and health visitors.

Working age people (including those recently retired and students)

Good

Updated 21 May 2015

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

There was an appropriate system of receiving and responding to concerns and feedback from patients in this group who had found difficulty in getting appointments. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflected the needs of this population group. The practice held a surgery 9am to 12.30pm on alternative Saturdays for those patients who found it difficult to get to the practice during normal working hours.

People whose circumstances may make them vulnerable

Good

Updated 21 May 2015

The practice is rated as good for the population group whose circumstances may make them vulnerable.

There was evidence of good multidisciplinary working with involvement of other health and social care workers. Staff were trained on safeguarding vulnerable adults and child protection.

The practice monitored a register which included patients receiving end of life and palliative care on a Gold Standard framework. The practice liaised on a regular basis with a community matron to ensure that any changes to patients’ conditions were discussed.

People experiencing poor mental health (including people with dementia)

Good

Updated 21 May 2015

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

The practice ensured that good quality care was provided for patients with mental health illnesses. The practice had a nominated lead who linked with other health professionals and community teams to ensure a safe, effective and co-ordinated service. The practice offered proactive, personalised care that met the needs of the older people in its population and had a range of enhanced services, for example in dementia. Data showed that this practice was in line with the national average score for dementia diagnosis in older patients.

Adults with mental health issues were included within a monitored list. We saw evidence of discussions by the GPs and other healthcare professionals concerning a patient with psychotic illness (schizophrenia) with coexisting organic problems.

Patients, who had a learning disability, were supported to live independently in the community.