Archived: Buckingham Road Surgery

Updated 16 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 12 May 2016 at Buckingham Road Surgery. The overall rating for the practice was good. However, the practice was rated as requires improvement for some aspects of providing safe services.

The full comprehensive report on the 12 May 2016 inspection can be found by selecting the ‘all reports’ link for Buckingham Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 16 August 2017 to confirm that the practice had carried out the improvements required that we identified in our previous inspection on 12 May 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Following this latest inspection the key question in relation to the provision of safe services at this location is now rated as good. The overall rating for the practice remains as good.

Our key findings were as follows:

• The practice had taken a systematic approach to review the findings of the 12 May 2016 inspection and we saw they had developed and implemented actions to rectify all areas that were recognised as requiring improvement.
• The practice had resealed the impermeable flooring in its treatment rooms so that there was no longer a potential infection control risk.
• The practice policy in relation to management of the cold chain had been reviewed and updated.  Staff we spoke with who were responsible for recording the daily fridge temperatures were aware of the process to take should the temperature range deviate outside the recommended +2 to 8°C. We found that all vaccines were in date. The practice had put a system in place to ensure that effective stock control was maintained.
• The practice had reviewed its recruitment policy and implemented a recruitment check list to enable all required documents and checks to be in place for newly recruited and existing personnel. We reviewed nine personnel files and found that appropriate recruitment checks had been undertaken.
• The practice had replaced the carpet in the waiting room and on the stairs. We observed that this was well fitted and no longer posed a trip hazard.
• All the medicines for use in a medical emergency were in date and stored securely. We observed there was oxygen warning signage on the door where oxygen was stored.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 March 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was lower than the Clinical Commissioning Group (CCG) and national average. However, the practice had been proactive in improving the care provided to this population group.

• 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 including palliative care patients, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 27 March 2017

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 Accident and Emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice offered cervical screening tests and cervical screening rates were comparable to Clinical Commissioning Group (CCG) and national average. For example, the percentage of women aged 25-64 who had a cervical screening test in the last five years was 80%, compared to the CCG average of 78% and national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• Patients under two years of age were offered same day appointments and all parents were offered telephone consultations if appointments for children of any age group were not available on the same day.

• All mothers and babies had a named GP and same day appointments were available for pregnant women.

• We saw positive examples of joint working with midwives and school nurses.

Updated 27 March 2017

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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice had a patient alert system in place to enable receptionists to recognise older vulnerable patients requiring urgent GP access.

• At risk patients were screened for dementia and offered longer appointments.

Updated 27 March 2017

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.

Updated 27 March 2017

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

• The percentage of patients with mental health conditions who had their alcohol consumption recorded in the last 12 months was 95%; higher than the national average of 90%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia and there was evidence of joint working with the memory clinic.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 27 March 2017

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

• The practice held a register of patients living in vulnerable circumstances including homeless people, carers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients 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.