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Archived: Graham Road Surgery

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Updated 6 August 2014

Graham Road Surgery is a general medical practice (GP surgery) that provides NHS services to 3,000 patients in East Merton covering Mitcham, Figges Marsh and Gorringe Park areas. The provider is registered with the Care Quality Commission to provide the regulated activities: maternity and midwifery; treatment of disease disorder or injury and diagnostics and screening at one location, Graham Road. The practice is operated by a partnership of two GPs and a part time locum. One of the partners is the registered manager. The Surgery opening hours were between 09.00 and 19.00 Monday to Friday and from 10.00 and 12.30 on Saturdays. Outside of these hours patients rang the surgery and were put through to the NHS 111 service who assessed and if appropriate referred patients to the out of hours service provided by Harmoni - South West London.

We found the service was safe, effective, caring, responsive and well led. Feedback from patients indicated that they were satisfied with the arrangements for making an appointment, the repeat prescription process and the care and treatment they received, although we received negative comments about patients having to wait when attending an appointment. We saw patients were treated with dignity and respect by staff. Patients were involved in their treatment and given choices in referrals to other health services. Policies and procedures were in place for safeguarding, health and safety and infection control which staff had read and understood. Health and safety checks were completed, risk assessments were carried out and staff were aware of their responsibilities regarding safeguarding vulnerable adults and children. Clinical audits were completed and serious incidents were reported and learning was shared with all staff. We found systems in place to monitor and improve outcomes for patients. Annual medicine reviews were completed and the practice had links with other health and social care providers. Staff recruitment was in line with requirements. New staff completed an induction which included going through policies and procedures and how to use equipment and observing new staff to ensure they carried out their role to the required standard. GPs and staff were up to date with training and arrangements were in place for all staff to receive supervision and appraisals. The complaints policy was accessible to patients in the practice information booklet given to new patients and on the practice website. Staff meeting minutes showed learning from complaints and incidents were shared.

Inspection areas

Safe

Updated 6 August 2014

We found that there were arrangements in place to respond to the needs of this patient group. Patients we spoke with had been registered with the practice for many years and were happy and satisfied with the treatment they received. They said that they were able to make appointments to see their doctor, the system for repeat prescriptions worked for them, they were treated with respect and their privacy and dignity was maintained. There were clear arrangements for patients to have a named GP to co-ordinate their treatment.

The practice was accessible and reception staff were aware of patients who needed help and support entering and leaving the building. Home visits were provided for patients who were housebound, receiving end of life care and those too ill to attend the surgery. 

Effective

Updated 6 August 2014

We found that there were arrangements in place to respond to the needs of this patient group. There were systems in place to ensure on-going monitoring of long term conditions to check treatment plans remained appropriate and no new health conditions were developing. Two of the GPs had completed training in diabetes care and provided regular diabetes clinics. The nurse and GPs carried out regular checks on patients with asthma and breathing difficulties and heart disease. Annual medicine reviews were held to check that treatment remained appropriate and cost effective. Patients told us that the repeat prescription process was convenient. The practice offered smoking cessation support and carried out regular checks of lungs for patients who smoked. The practice had regular meetings with other health professionals which provided joined up care and treatment for patients. When patients were receiving end of life care this was recorded for the out of hours service.

Caring

Updated 6 August 2014

We found that there were arrangements in place to respond to the needs of this patient group. The practice employed a nurse who provided health checks and immunisations in line with the ‘Healthy Child Programme’ for babies and children. New mothers were given the six week check, which included screening for depression which meant that any referrals needed could be made quickly. The practice website and information leaflet noted that contraceptive and sexual health advice was provided and chlamydia tests could be carried out at the practice.

There was a female locum GP for patients who preferred to see a female doctor. A chaperone policy was in place (this is when another member of staff is present during an examination or consultation).

Staff told us that they were able to give priority, same day appointments to babies and young children when they were unwell.

Systems were in place for communication with other health and social care professionals which meant patients received joined up care and treatment.

The recording system identified when children were looked after by the local authority and the GPs were aware of the need for annual health checks for these patients.

Responsive

Updated 6 August 2014

We found that there were arrangements in place to respond to the needs of this patient group. Patients were offered regular reviews of treatment and annual reviews of medicines to ensure they remained appropriate. There were suitable processes in place for patients to request repeat prescriptions. The surgery worked with other health and social care professionals which offered joined up care for patients. An example of this was the three monthly meetings held with mental health professionals.

Well-led

Updated 6 August 2014

We found that there were arrangements in place to respond to the needs of this patient group. We were told that the doctors would see any patient who attended the practice. There were low numbers of patients with learning disabilities. These patients were offered annual health checks and medication reviews. There was a chaperone policy in place, this meant relatives and carers could attend these appointments and the nurse was available if required. Referrals were made to other health and social care services so vulnerable patients accessed appropriate services to meet their individual needs. Policies for safeguarding were in place and staff were aware of actions they needed to take to raise concerns to the local authority. The practice had access to translators and British Sign Language interpreters when required.