You are here

Inspection Summary


Overall summary & rating

Good

Updated 31 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Omnia Practice on 1 April 2016. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were maximised.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. There was a strong culture for learning. Staff received regular supervision and learning opportunities.
  • The practice worked closely with other services and with the local community to ensure patients’ needs were met. The practice offered a variety of in-house services for the convenience of patients for diagnosis and treatment. For example, sexual health services.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. This included changes to telephone system, staffing in reception and changes within the premises. The practice explored and used new ways for communicating with its population, such as twitter. There was an attention to detail when delivering care for example in ensuring continuity of care, while maintaining confidentiality and infection control.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. The practice allowed its premises for use by community groups and services that would enhance the wellbeing of its population. For example, Saheli exercise classes for women, Age UK and carers groups.
  • Information about how to complain was available and easy to understand
  • There was strong leadership within the practice and staff felt well supported.

We saw areas of outstanding practice:

  • The practice provided dedicated sexual health and contraceptive services for registered and non-registered patients under the Umbrella Scheme. The Umbrella scheme which is part of University Hospitals Birmingham NHS Foundation Trust aims to improve access and outcomes for patients in sexual health. Trained staff provided contraceptive and family planning services and treatment of sexually transmitted diseases to registered and non-registered patients with the practice on a walk in basis. The practice also offered training (and had qualified trainers) for health professionals as part of the sexual and reproductive health diploma course.
  • Carers were well supported at the practice. The practice had a carers champion and ran a carers’ group open to carers within the locality. Carers did not need to be registered with the practice to join. Members of the group spoke highly of the support they had received and had access to external speakers. Information for carers was displayed prominently to encourage carers to come forward. The practice also hosted from the premises a new scheme with Age UK to provide social support for those who were isolated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 31 May 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.
  • Lessons were shared to make sure action was taken to improve safety in the practice.
  • Patients were informed of unintended or unexpected safety incidents affecting them and where appropriate received an explanation and apology.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 31 May 2016

The practice is rated as good for providing effective services.

  • Given the high level of deprivation and transient population the practice performed highly against the Quality and Outcomes Framework. Patient outcomes were in most cases above average for the locality and compared to the national average with overall lower levels of exception reporting.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • There was a strong focus on learning and development. With all clinical staff receiving weekly supervision and learning session to ensure they had the skills, knowledge and experience to deliver effective care and treatment. These were valued by staff.
  • The practice worked effectively with health and social care colleagues to ensure patients received positive outcomes. For example weekly meetings on a Friday with the district nurse to identify any problems which may arise over the weekends and direct contact to clinicians at weekends.

Caring

Good

Updated 31 May 2016

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. Information and access to translation services was provided for those whose first language was not English.
  • The practice actively promoted and supported the carers’ agenda.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 31 May 2016

The practice is rated as good for providing responsive services.

  • The practice engaged with the local Clinical Commissioning Group and practices within their locality to secure improvements in services provided for their population.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Results from the latest National GP Patient Survey (published January 2016) were mixed in relation to access. Scores for patients who said they were satisfied with opening times were higher than CCG and national averages but lower with regards to getting through on the phone and being able to see or speak to their preferred GP.
  • Urgent appointments were available the same day.
  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised.

Well-led

Good

Updated 31 May 2016

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.
  • The strong leadership, governance and culture of the organisation helped to drive and improve the delivery of high quality person centred care.
  • The practice was well organised and adapted positively to the needs of a challenging population group that was culturally diverse and had high levels of deprivation. It was proactive in identifying different ways of working to meet the changing needs of the population.
  • There was a strong culture for learning and staff development, the practice invested in their staff so that they had the skills needed to deliver the service and patient care.
  • Governance arrangements and performance management arrangements reflected evidence of best practice. The practice performed well against national standards and targets.
  • The provider was aware of and complied with the requirements of the Duty of Candour. The partners encouraged a culture of openness and honesty. Systems for managing safety incidents ensured appropriate action was taken and learning took place.
  • The practice was proactive in using new technology to engage with patients. Feedback from patients had influenced changes in the practice.
Checks on specific services

People with long term conditions

Good

Updated 31 May 2016

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

  • Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and received regular reviews of their care.
  • Dedicated clinics for coronary heart disease and diabetes (including insulin initiation) were held at the practice.
  • For the convenience of patients various in-house diagnostic and monitoring services were available to support the identification and management of long term conditions including spirometry, ambulatory blood pressure monitoring and anticoagulation services.
  • The practice’s QOF performance for diabetes related indicators was 96% which was higher than both the CCG average and national average of 89%.
  • Longer appointments and home visits were available for those who needed them.

Families, children and young people

Good

Updated 31 May 2016

The practice is rated as good for the care of families, children and young people.

  • The practice population for patients under 18 years was significantly higher at 38% than the CCG average (24%) and national average (21%).
  • There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. The practice worked with the health visiting team to follow up any concerns.
  • Reported immunisation rates for 2014/15 were lower than the CCG and national averages. However the practice told us that there has been a discrepancy between their immunisation data and that produced centrally which they have not been able to resolve. The practice spoke about difficulties faced through the growth in the population and supporting cultural differences towards immunisation. Latest data seen from the practice showed uptake of MMR for children under 24 months was 96.3% and preschool booster 93.8%. The practice told us that they were achieving 90% for the majority of childhood immunisations.
  • The percentage of patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was 71% which was comparable to the CCG average of 74% and national average of 75%.

  • Children were prioritised as for same day appointments and patients we spoke with confirmed they had no difficulties making an appointment for a child. Appointments were available outside of school hours and the premises were suitable for children and babies.
  • The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 79% and the national average of 82%.

Older people

Good

Updated 31 May 2016

The practice is rated as good for the care of older people.

  • The practice population for patients over 75 years was significantly lower at 3.4% than the CCG average (6.9%) and national average (7.8%).
  • The practice offered proactive, personalised care to meet the needs of the older people in its population.
  • Patients aged over 75 years had a named GP responsible for their care.
  • Those identified as being at high risk of admission and with complex care needs were prioritised for a review of their care needs. These took place every 14 weeks and if necessary would be carried out as a home visit to ensure no one was missed.
  • The practice held regular multi-disciplinary team meetings with district nurses, palliative care nurses and case managers to meet the needs of those at the end of life.
  • Meetings took place every Friday with the district nurse to minimise and deal with any potential issues that may arise during the weekend when the practice was closed. The District nurse could contact the on call GP at the weekend if needed.
  • The practice offered home visits and urgent appointments for those with enhanced needs.
  • The premises were accessible to patients with mobility difficulties.
  • Flu and shingles vaccinations were available at the practice for relevant patients.
  • The practice was participating in a CCG led scheme with Age UK to provide additional social support to those who were isolated. The practice had identified potential patients who might benefit and the scheme was shortly due to go live. The practice hosted Age UK from its premises.
  • The practice undertook twice weekly ward rounds as an enhanced service at two large local care homes and we received positive feedback on the care and support provided by the practice, as well as from carers about the support provided for them and their relatives.

Working age people (including those recently retired and students)

Outstanding

Updated 31 May 2016

The practice is rated as outstanding for the care of working-age people (including those recently retired and students).

  • The practice had a high proportion of patients who were under the age of 40 years. The practice explained that the population had changed significantly over the last few years with an increase in immigrants from a range of different nationalities and how services had changed in response.
  • The practice provided dedicated sexual health and contraceptive services for registered and non-registered patients under the Umbrella Scheme. The Umbrella scheme which is part of the University Hospitals Birmingham NHS Foundation Trust’s aims to improve access and outcomes for patients in sexual health by providing a range of contraceptive and family planning and treatment of sexually transmitted diseases. The service was open to registered and non-registered patients with the practice. The practice also offered training (and had qualified trainers) for health professionals as part of the sexual and reproductive health diploma course.
  • The practice was proactive in offering online services, in addition to online appointments the practice made use of texting to remind patients of appointments and to make it easier for patients to cancel appointments no longer required. The practice had a twitter account to facilitate communication with its practice population. A self check in also reduced the patients’ needs to queue at reception and was available in multiple languages.
  • Extended opening hours were available three nights a week offering GP and nurse appointments up to 8pm.
  • NHS health checks were also available to this population group.

People experiencing poor mental health (including people with dementia)

Good

Updated 31 May 2016

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

  • National reported data from 2014/15 showed that 97% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the previous 12 months. This was above the CCG average of 82% and national average of 84%.
  • National reported data from 2014/15 showed performance against mental health related indicators was at 98% which was above the CCG average of 92% and the national average of 93%.
  • The practice hosted Birmingham Healthy Minds. A service offering advice, information and psychological therapies for those with anxiety or depression which patients could access.
  • The practice carried out ward rounds in a home specialising in dementia care and worked closely with the psychiatric consultant to ensure patients received appropriate care.

People whose circumstances may make them vulnerable

Good

Updated 31 May 2016

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

  • The practice is located in an area of high deprivation. Food bank vouchers were authorised through the practice for those who needed them. The practice registered patients with no fixed abode and in temporary accommodation.
  • An in-house substance misuse clinic operated weekly.
  • The practice had a carers’ champion who supported the carers’ group. Members of the group spoke highly of the support they had received and had access to external speakers. Information for carers was displayed in the reception area.
  • Information was available in languages other than English and translation and interpreter services were available to patients who needed them.
  • 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 Citizens Advice Bureau provided weekly sessions at the practice.