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Claremont Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 26 November 2018

This practice is rated as Good overall. (Previous rating 03 2018 – Requires Improvement)

The key questions at this inspection are rated as:

Are services safe? – Not rated

Are services effective? – Not rated

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Not rated

We carried out an announced comprehensive inspection at Claremont Medical Centre on 16 January 2018 to follow up on breaches of regulations 17, 18 and 19, found at our inspection in March 2016 where the practice was rated as requires improvement overall. At the inspection in January 2018 the practice was rated requires improvement for being caring and responsive and issued with a requirement notice for a breach in regulation 17. This led to an overall rating of requires improvement.

This inspection was an announced focussed follow-up inspection on 9 October 2018, carried out to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation identified in our previous inspection on 16 January 2018. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found:

  • The practice had good facilities, including a hearing loop and was well equipped to treat patients and meet their needs.
  • Vital signs were documented for patients who attended the practice for acute illnesses.
  • The practice had a system to capture, respond to and learn from verbal complaints.
  • Learning and outcomes from incidents and changes made in the practice was cascaded to all staff members.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The practice had increased their opening hours and appointments could now be booked on an App.
  • National GP patient survey results were now in line with local and national averages for the practice showing care and concern and access to care and treatment.

The areas where the provider should make improvements are:

  • Continue to work to improve patient satisfaction with services provided.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information

Inspection areas

Safe

Good

Updated 12 March 2018

Effective

Good

Updated 12 March 2018

Caring

Good

Updated 26 November 2018

At our previous inspection on 16 January 2018, we rated the practice as requires improvement for providing caring services as the National GP patient survey results were below local and national averages and the practice could not demonstrate what they had done to address these.

These arrangements had significantly improved when we undertook a follow up inspection on 9 October 2018. The practice is now rated as good for providing caring services.

Kindness, respect and compassion

Staff treated patients with kindness, respect and compassion.

  • Staff understood patients’ personal, cultural, social and religious needs.
  • The practice gave patients timely support and information.
  • The practices national GP patient survey results showed marked improvement on the previous years results and were in line with local averages but sometimes below national averages for questions relating to kindness, respect and compassion. The practice acted to improve this and completed their own patient survey which had positive results.
  • The practice carried out their own patient satisfaction survey, the results of which were positive about the levels of kindness and care received.

Involvement in decisions about care and treatment

Staff helped patients to be involved in decisions about care and treatment. They were aware of the Accessible Information Standard (a requirement to make sure that patients and their carers can access and understand the information that they are given).

  • Staff communicated with people in a way that they could understand, for example, communication aids and easy read materials were available.
  • A hearing loop was installed to help people with hearing difficulties.
  • Staff helped patients and their carers find further information and access community and advocacy services. They helped them ask questions about their care and treatment.
  • The practice proactively identified carers and supported them.
  • The practices national GP patient survey results were in line with local averages and sometimes below national averages for questions relating to involvement in decisions about care and treatment. The practice had taken steps to improve this and their own patient survey had positive results in relation to this.

Privacy and dignity

The practice respected patients’ privacy and dignity.

  • When patients wanted to discuss sensitive issues, or appeared distressed reception staff offered them a private area to discuss their needs.
  • Staff recognised the importance of people’s dignity and respect. They challenged behaviour that fell short of this.

Please refer to the evidence tables for further information.

Responsive

Good

Updated 26 November 2018

At our previous inspection on 16 January 2018, we rated the practice as requires improvement for providing responsive services as patients rated the practice below average on how they could access care and treatment.

These arrangements had significantly improved when we undertook a follow up inspection on 9 October 2018. The practice and all of the population groups are now rated as good for providing responsive services.

Responding to and meeting people’s needs

The practice organised and delivered services to meet patients’ needs. It took account of patient needs and preferences.

  • The practice understood the needs of its population and tailored services in response to those needs.
  • Telephone consultations were available each lunch time, which supported patients who were unable to attend the practice during normal working hours.
  • The facilities and premises were appropriate for the services delivered.
  • The practice made reasonable adjustments when patients found it hard to access services.
  • The practice provided effective care coordination for patients who are more vulnerable or who have complex needs. They supported them to access services both within and outside the practice.
  • Care and treatment for patients with multiple long-term conditions and patients approaching the end of life was coordinated with other services.

Older people:

  • All patients had a named GP who supported them in whatever setting they lived in.
  • The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. The GP and practice nurse also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability.
  • There was a medicines delivery service for housebound patients.

People with long-term conditions:

  • Patients with a long-term condition received an annual review to check their health and medicines needs were being appropriately met. Multiple conditions were reviewed at one appointment, and consultation times were flexible to meet each patient’s specific needs.
  • The practice held regular meetings with the local district nursing team to discuss and manage the needs of patients with complex medical issues.

Families, children and young people:

  • We found there were systems 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 accident and emergency (A&E) attendances. Records we looked at confirmed this.
  • All parents or guardians calling with concerns about a child under the age of five were offered a same day appointment when necessary.

Working age people (including those recently retired and students):

  • The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. For example, the practice was a part of a local HUB which offered GP and nurse appointments on weekday evenings and weekends when the practice was closed.
  • Telephone consultations were available each day.
  • The practice signed up to an App which patients could download and use to book appointments and request medicines.

People whose circumstances make them vulnerable:

  • The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
  • People in vulnerable circumstances were easily able to register with the practice, including those with no fixed abode.

People experiencing poor mental health (including people with dementia):

  • Staff interviewed had a good understanding of how to support patients with mental health needs and those patients living with dementia.
  • These patients were offered an annual review of their health needs and were followed up if they did not attend.

Timely access to care and treatment

Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.

  • Patients had timely access to initial assessment, test results, diagnosis and treatment.
  • Waiting times, delays and cancellations were minimal and managed appropriately.
  • Patients with the most urgent needs had their care and treatment prioritised.
  • The practices GP patient survey results were in line with local averages but sometimes below national averages for questions relating to access to care and treatment. The practice had taken action to improve this and their own patient survey rated them positively.

Listening and learning from concerns and complaints

The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.

  • Information about how to make a complaint or raise concerns was available. Staff treated patients who made complaints compassionately.
  • The practice held a book in the reception area to document verbal complaints.
  • The complaint policy and procedures were in line with recognised guidance. The practice learned lessons from individual concerns and complaints and also from analysis of trends. It acted as a result to improve the quality of care.

Please refer to the evidence tables for further information.

Well-led

Good

Updated 12 March 2018

Checks on specific services

People with long term conditions

Good

Families, children and young people

Good

Older people

Good

Working age people (including those recently retired and students)

Good

People experiencing poor mental health (including people with dementia)

Good

People whose circumstances may make them vulnerable

Good