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East Hull Family Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Morrill Street Group Practice on 8 September 2015.

Overall the practice is rated as good.

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

  • Two week pre-bookable and urgent appointments were available the same day.
  • The practice had good facilities including disabled access to first floor consulting rooms.
  • Information about services and how to complain was available in the practice leaflet and on their website. The practice sought patient views about improvements that could be made to the service.
  • The practice proactively sought to educate their patients to manage their medical conditions and improve their lifestyles by having additional in house services available. These included smoking cessation and long term conditions clinics.
  • There were systems in place to reduce risks to patient safety for example, infection control procedures.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
  • The practice made good use of audits and had shared information from their audits with staff to promote better patient outcomes.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

  • Ensure all staff appraisals are completed in line with the practice policy arrangements.
  • Ensure infection control training is completed for all staff in the practice in particular to basic hand washing techniques.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 19 November 2015

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were sufficient numbers of staff with an appropriate skill mix to keep patients safe. However, not all staff had completed infection control training. Appropriate recruitment checks had been carried out on staff.

Effective

Good

Updated 19 November 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were at or above average for the locality. Staff referred to guidance from the National Institute for Health and Care Excellence and used it routinely. Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training appropriate to their roles and any further training needs had been identified and appropriate training planned to meet these needs. There was evidence of some staff appraisals and personal development plans, however, not all staff appraisals had been completed. Staff worked with multidisciplinary teams.

Caring

Good

Updated 19 November 2015

The practice is rated as good for providing caring services. Patients’ views gathered at inspection demonstrated they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We also saw that staff treated patients with kindness and respect and maintained confidentiality. Data from the National GP Patient Survey showed that patients rated the practice as slightly above others for several aspects of care compared to local and national averages.

Responsive

Good

Updated 19 November 2015

The practice is rated good for providing responsive services. It reviewed the needs of its local population and engaged with the local Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. Services were planned and delivered to take into account the needs of different patient groups. The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and evidence showed that the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 19 November 2015

The practice is rated good for being well-led. It had a clear vision and strategy. Governance arrangements were underpinned by a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity. There were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients, which it acted on. Staff had received inductions, regular performance reviews and attended staff meetings and events. However, some staff had their appraisals yet to be completed. The practice was aware of future challenges.

Checks on specific services

People with long term conditions

Good

Updated 19 November 2015

The practice is rated good for the care of people with long-term conditions. These patients had a regular review with either the GP and/or the nurse to check their health and medication. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Patients were encouraged to manage their conditions and were referred to health education and other in-house services when necessary, for example a dietician. Longer appointments and home visits were available when needed. Patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people 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 19 November 2015

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 good 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 19 November 2015

The practice is rated good for the care of older people. The practice offered proactive, personalised care to meet the needs of the older people in its population, if necessary as well as rapid access appointments for those with enhanced needs. The practice offered home visits and usual doctor appointments to improve continuity of care. The practice had regular contact with community nurses and participated in meetings with other healthcare professionals to discuss any concerns.

Working age people (including those recently retired and students)

Good

Updated 19 November 2015

The practice is rated good for the care of 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. For example, the practice opened evenings until 6.00pm for those people who could not attend during normal opening hours. The practice could also refer patients to their branch surgery at peak times. A dedicated on-call GP was available for emergency telephone advice and dedicated receptionist time for obtaining test results. The practice also offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 19 November 2015

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). 97% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advanced 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 19 November 2015

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. It had carried out annual health checks for people with a learning disability and 100% of these patients had received a follow-up.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff had been trained 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.