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Archived: Modality Attwood Green Good Also known as The Hyman Practice

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 17 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Modality Attwood Green on 2 March 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and a system was in place for reporting and recording significant events. The practice had recorded and analysed significant events to identify areas of learning, and improvements were made to prevent the risk of further occurrence.

  • Arrangements were in place to safeguard children and vulnerable adults from abuse, and local requirements and policies were accessible to all staff.

  • Staff spoken with were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

  • The practice had joined a corporate provider (Modality) and had applied to the CQC to ensure this was reflected in their registration. Patients we spoke with said there had been some changes to staff members and the way the service was being delivered as a result of the changes.

  • Patients told us that they found it easy to make an appointment and there was continuity of care. Urgent appointments were available on the day when necessary.

  • Clinical audits were carried out to demonstrate quality improvement and to improve patient care and treatment.

  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs. The new provider (Modality) held monthly clinical management meetings which were attended by the lead GP. This facilitated management of poor performance and to exchange good practice across the organisation.

  • The practice was located on the second floor of a purpose built health centre. The building was accessible and lifts were available for those patients who had difficulty with their mobility.

  • There was a clear leadership structure both at corporate level and at practice level and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

  • Information about services and how to complain was available in various community languages. Improvements were made to the quality of care as a result of complaints and concerns.

  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 May 2017

The practice is rated as good for providing safe services.

  • From the sample of documented examples we reviewed, we found there was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice. When things went wrong patients were informed as soon as practicable, received reasonable support, truthful information, and a written apology.
  • There was an effective system in place to ensure all alerts were reviewed and acted on appropriately, including alerts received from the Medicines and Healthcare products Regulatory Agency (MHRA).
  • Staff demonstrated that they understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.
  • We observed the premises to be visibly clean and tidy. There were adequate arrangements in place to deal with emergencies and major incidents.

Effective

Good

Updated 17 May 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were generally above the local CCG and national averages.
  • Staff assessed needs and delivered care in line with current evidence based guidance. Clinical audits were carried out and they demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

  • End of life care was coordinated with other services involved.
  • Monthly clinical management meetings were held at the provider level attended by the lead GP. This helped them to manage poor performance and to exchange good practice across the organisation.

Caring

Good

Updated 17 May 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 17 May 2017

The practice is rated as good for providing responsive services.

  • The practice understood its population profile and had used this understanding to meet the needs of its population. For example, the practice increased access to appointments and the offered more online and telephone consultation as a result of patient requests.

  • Patients said they found it easy to make an appointment with the GPs and there was continuity of care.

  • For convenience, patients could access services such as the electrocardiographs (ECGs) at the practice. This was part an arrangement with the Clinical Commissioning Group (CCG).

  • There were longer appointments available at flexible times for people with a learning disability and for patients experiencing poor mental health. Same day appointments were also available for children and those who needed to see a doctor urgently.

  • There were disabled facilities and translation services available. The practice had a hearing loop in place and alerts were added to patients’ records where support may be required.
  • The practice was located on the second floor of a purpose built health centre. Lifts were available and the practice had good facilities to treat patients and meet their needs.
  • Information about how to complain was available in various languages and evidence showed the practice responded quickly to issues raised. Complaints and incidents were discussed and learning was shared with staff.

Well-led

Good

Updated 17 May 2017

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Its vision and values were displayed in the waiting area and staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff felt supported by management. The practice had policies and procedures to govern activity and held regular governance meetings.
  • The practice had joined a corporate provider and there was a central governance team who helped to support the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • Evidence we looked at confirmed that staff had received inductions and attended staff meetings and training opportunities.

  • The provider was aware of the requirements of the duty of candour. A record of an incident we reviewed demonstrated that the practice complied with these requirements.
  • The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.
  • The practice proactively sought feedback from staff and patients and we saw examples where feedback had been acted on. The practice engaged with the patient participation group (PPG).
  • The practice had joined a corporate provider and had access to the central governance team who helped to support the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

Checks on specific services

People with long term conditions

Good

Updated 17 May 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.
  • The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was at or below target level, was 94%. This was above the CCG average of 90% and the national average of 91%.
  • The practice provided additional diabetic services. A Diabetes Consultant held clinics (mix of face to face and virtual) for more complex cases. This was as part of the Diabetes Inpatient Care and Education (DICE) programme, a CCG funded area of enhanced care.
  • Other long term conditions such as chronic obstructive pulmonary disease (COPD), asthma and hypertension showed patient outcomes were above CCG and national averages.
  • The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
  • The provider offered services to support the diagnosis and monitoring of patients with long term conditions such echocardiograms (ECG) and spirometry. Health promotion support was also available such as smoking cessation.

Families, children and young people

Good

Updated 17 May 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.
  • The practice was located on the second floor of a purpose built health centre and was suitable for children and babies and lifts were available.
  • There were policies, procedures and contact numbers to support and guide staff should they have any safeguarding concerns about children. The practice discussed any safeguarding concerns as part of two monthly multidisciplinary meetings with relevant health professionals.
  • We saw positive examples of joint working with midwives and health visitors. The practice provided immunisation clinics for children and provided postnatal checks.
  • Immunisation rates were low for all standard childhood immunisations. The practice was aware of this and was working to address this.
  • Appointments were available outside of school hours.
  • The practice’s uptake for the cervical screening programme (in the preceding five years) was 81%. This was comparable to the CCG average of 80% and the national average of 81%.

Older people

Good

Updated 17 May 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 patients in its population.
  • The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
  • The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. Patients who were discharged from hospital were reviewed to establish the reason for admission and care plans were updated.
  • The practice worked closely with multidisciplinary teams so patients’ conditions could be safely managed in the community. Patients could be referred to other local practices that were part of the same provider offering additional services such as Urology, Rheumatology as well as Ear Nose and Throat (ENT) services. This provided convenience for patients who did not have to travel to hospital for the service

  • The practice was accessible to those with mobility difficulties.

Working age people (including those recently retired and students)

Good

Updated 17 May 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 had a significantly higher than national average working age patients registered at the practice. The practice had increased the number of online and telephone consultations as a result of feedback from patients. It also offered early morning appointments from 7am to 8am on Mondays.
  • Patients could access appointments and services in a way and at a time that suited them. Appointments could be booked over the telephone, face to face and online.
  • The practice provided an electronic prescribing service (EPS) which enabled GPs to send prescriptions electronically to a pharmacy of the patient’s choice.

  • The practice offered a range of health promotion and screening that reflects the needs for this age group. This included NHS health checks.

People experiencing poor mental health (including people with dementia)

Good

Updated 17 May 2017

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

  • The practice carried out advance care planning for patients living with dementia. Seventy percent of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was below the CCG average of 84% and the national average of 84%. We asked the practice to provide us with data from 2016-17 which showed that 83% of patients diagnosed with dementia had their care reviewed in a face to face meeting. Although this demonstrated improvement, this was unverified and unpublished data.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia. We looked at some mental health care plans and saw that some had input from external mental health teams.
  • The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
  • The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 94%, compared to the CCG average of 91% and the national average of 89%.
  • The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health. The GP told us that they initially followed this up with a telephone call.

People whose circumstances may make them vulnerable

Good

Updated 17 May 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, travellers and those with a learning disability.
  • The practice was located near the city centre of Birmingham and staff were aware of and could demonstrate understanding of some of the barriers faced by vulnerable patients.
  • Staff had attended external training to understand the barriers (to healthcare) faced by patients from vulnerable groups.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients and held meetings with the district nurses and community teams.

  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
  • The practice’s computer system alerted GPs if a patient was also a carer. There were 41 patients on the practices register for carers; this was 1% of the practice list. There was supportive information in place for carers to take away as well as information available through the practice website. The practice offered annual reviews and flu vaccinations for anyone who was a carer.