• Doctor
  • GP practice

Archived: Victoria Park Medical Centre

Overall: Good read more about inspection ratings

Victoria Park Drive, Bridgwater, Somerset, TA6 7AS (01278) 437100

Provided and run by:
Victoria Park Medical Centre

Important: The provider of this service changed. See new profile

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Background to this inspection

Updated 2 February 2017

The practice is located in Bridgwater, a town close to the M5 motorway, eight miles south west of Taunton, on the edge of the Somerset Levels in the Sedgemoor district of the county of Somerset. The practice provides primary medical services for the town and some surrounding rural villages and hamlets.

The practice is located in a purpose built building within a community development which was built in 2006 in the grounds of a recreation park. The facilities include a pharmacy, children’s nursery and a children’s centre. Active living programmes and a green gym within the park are examples of services provided to the local community.

The practice has a population of approximately 4661 patients. The practice has a significantly higher than England average number of patients aged 0-14 years of age and a significantly lower than England average number of patients over 65 years of age. The practice has a high level of deprivation with a score of 26 which is higher than the England average of 22 and the Somerset average of 18.

The public health profile for the practice shows it has a higher rate of mortality and a much less healthy population when compared to local and national data. For example, obesity, smoking and drug and alcohol addictions are all higher than the Somerset average. The practice population has the worst unemployment in Somerset and 32% of the patients live in one of the most deprived areas in Somerset.

The practice has a Primary Medical Services contract (PMS) with NHS England to deliver primary medical services. The practice provides enhanced services which include facilitating timely diagnosis and support for patients with dementia; childhood immunisations and enhanced hours patient access.

Dr Lewis is currently in the process of changing to sole provider registration with the Care Quality Commission following the departure of two GP partners. The Primary Medical Services contract is held by Dr Lewis.

The practice team includes a male salaried GP and a regular female locum GP whom together with Dr Lewis provides the practice with 16 GP sessions per week. A female nurse practitioner provides 4 sessions per week. In addition the team comprises of two female practice nurses, one health care assistant, an interim practice manager and eight part time administrative staff which include a prescribing clerk, receptionists and secretaries. A new health care assistant and receptionist had been employed by the practice and were shortly due to commence work.

The GPs had special interests and additional skills in areas including substance misuse; obesity and bariatric surgery.

The practice is open between 8am to 7.30pm on Monday and 8am to 6.30pm Tuesday to Friday. Appointments are pre-bookable up to six weeks in advance and are for 10 minutes each.

Since our previous inspections in February 2016 and June 2016 the practice had installed a new telephone system providing more accessible lines into the practice. In addition they had recently commenced a change to appointments for GPs by allocating less routine pre-bookable appointments. Patients were now able to telephone on the day and speak to or see a GP.

The practice has opted out of providing Out Of Hours services to their own patients. Patients can access NHS 111 and Somerset Urgent Care Doctors provide an Out Of Hours GP service.

Overall inspection

Good

Updated 2 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Victoria Park Medical Centre (previously Doctors Lewis, Hawkes and Dicks) on 30 November 2016 to check if improvements have been made in response to our previous inspection on 3 February 2016 when the practice was placed in special measures following an overall rating of inadequate. Overall the practice is now rated as good.

On 3 February 2016 we found the practice was inadequate for the safe and well led domains and required improvement for the responsive domain. We found the practice was good for effective and caring domains. This led to an overall rating of inadequate. We also rated the services for the specific population groups inadequate to align with these ratings. Following the inspection, which raised significant concerns, we placed the practice into special measures. Being placed into special measures represents a decision by Care Quality Commission (CQC) that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

We issued warning notices in regard to:

  • Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Good Governance.
  • Regulation 18 of the Health and Social Care Act (Regulated Activity) Regulations 2014, Staffing.

On 16 June 2016 we inspected the practice to check compliance had been met in regard to the warning notices. We found the provider had made significant steps to ensure the concerns which had been found previously in relation to the warning notices for Regulations 17 and 18, had or were in the process of, being addressed. The practice remained under special measures until we returned to carry out a comprehensive inspection at the end of the six month period after the initial report was published.

Our key findings across all the areas we inspected on 30 November 2016 were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained, to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • The practice had a higher than local average of patients recorded as obese. They had undertaken an audit on patients who had undergone bariatric surgery and developed a register of these patients. A recall system for follow up tests, injections and annual reviews had bene implemented. (Bariatric surgery is a procedure to reduce weight through reduction of the size of the stomach).
  • 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. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent and routine 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.
  • The provider was aware of and complied with the requirements of the duty of candour.

However there were areas of practice where the provider should make improvements:

  • The provider should have a system in place to demonstrate action is taken to address any improvements when highlighted in infection control audits.

This service was placed in special measures in April 2016 in order for the provider to take steps to improve the quality of the services it provided. I am taking this service out of special measures. This recognizes the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 2 February 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.
  • Data showed performance for diabetes related indicators was comparative to local and national averages.
  • 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, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 2 February 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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
  • Patients told us children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
  • Cervical smear data showed the practice performance was comparative to local and national data.
  • Appointments were available outside of school hours and the premises were suitable for children and babies. The practice was situated within a community centre which had a nursery school making access for families easier.
  • We saw positive examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 2 February 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.
  • Patients identified as at risk of admission to hospital had a care plan.
  • Patients over the age of 75 had a named GP.

Working age people (including those recently retired and students)

Good

Updated 2 February 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 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.
  • Extended hours appointments were available.

People experiencing poor mental health (including people with dementia)

Good

Updated 2 February 2017

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

  • The percentage of the practice population with dementia was 0.56%, 80% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average.
  • Data showed performance for mental health related indicators was comparable to local and national averages.
  • 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.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 2 February 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 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.
  • The practice provided specialised care for patients with substance misuse.