• Doctor
  • GP practice

Lepton & Kirkheaton Surgeries

Overall: Good read more about inspection ratings

Lepton Surgery, Highgate Lane, Lepton, Huddersfield, West Yorkshire, HD8 0HH (01484) 606161

Provided and run by:
Lepton & Kirkheaton Surgeries

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Background to this inspection

Updated 9 February 2017

Lepton and Kirkheaton Surgeries are housed within two purpose built premises in a semi-rural area of Huddersfield. The main registered location is the Lepton Surgery, Highgate Lane, Lepton, Huddersfield, HD8 0HH. Kirkheaton is a somewhat smaller premises and is a branch surgery located three miles away. The branch address is: Kirkheaton Surgery, Heaton Moor Road, Kirkheaton, Huddersfield, HD5 0ET. Both sites were visited as part of the inspection.

The practice serves a combined patient list of 7388. The area is relatively affluent and has lower levels of deprivation when compared to neighbouring practices within the Huddersfield area and also nationally.

There are two full time male GP partners. They are supported by a full-time male and two part-time female salaried GPs.

There are three part-time female practice nurses, whose working hours are equal to two whole time equivalent staff. There are two part-time female health care assistants, one of whom also works as a phlebotomist four days a week. A pharmacist is also employed on a part-time basis.

The practice manager is supported by a full time reception manager who supervises the receptionist and administration teams across both locations.

The provider is open Monday-Friday 8.30am to 6pm, with each location closing for lunch for one hour. There is also half day closing at both sites once a week. Lunch and surgery closures are staggered between the two locations to provide continuity for patients throughout the day. Appointments with a GP or nurse are offered throughout the day and a GP extended hours service is offered at Lepton surgery on a Tuesday evening between 6.30-8.30pm. This equals 4 hours of extended service and allows patients to access both a male and female GP at these times.

Doctors attend surgeries at both locations whilst the surgery at Lepton has two nurses and the Kirkheaton branch employs one nurse.

Care is delivered as part of a Primary Medical care (PMS) contract and when the surgery is closed out of hours care is provided by Local Care Direct.

This practice was first inspected on 21January 2016, and was found to be inadequate overall and placed into special measures.

At the January 2016 inspection the practice was rated inadequate in safe, effective and well led. It was rated as requires improvement in caring and responsive.

Overall inspection

Good

Updated 9 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lepton & Kirkheaton Surgeries on 15 November 2016. This was to check that the practice had taken sufficient action to address a number of significant shortfalls we had identified during our previous inspection on 21 January 2016. Following this inspection, the practice was rated as inadequate for providing safe, effective and well-led services; and requires improvement for providing caring and responsive services. Overall it was rated as inadequate. We also issued three warning notices under the Health and Social Care Act 2008 to accompany our inspection report and placed the practice into special measures as a result.

During our most recent inspection, we found that the practice had taken action to remedy the breaches in regulations. For example, health and safety concerns had been addressed, outdated policies had been reviewed, effective clinical audits were being undertaken, deficits in staff training had been rectified and systems to ensure the safe management of vaccines had been implemented. Overall the practice is now 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 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.
  • 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 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.

The areas where the provider should make improvement are:

  • Continue to review and address issues raised in the national patient survey to assure themselves that improvements that have already been made are sustained and have had a positive impact.

  • Continue to address performance in the Quality and Outcomes Framework (QOF) in the area of mental health services to effect continued improvement.

I am taking this service out of special measures. This recognises 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 9 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 and reviewed by GPs.

  • Overall QOF achievement for treatment of diabetes was 91%, which was 3% higher than the local average and 1% higher than the national average.

  • 81% of patients with asthma had received an annual review which was 4% higher than the local average and 5% higher than the national average.

  • Longer appointments and home visits were available when needed.

  • All these patients had a named GP and were offered 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. For example, by referring cases to a visiting diabetic consultant or diabetic specialist nurse.

Families, children and young people

Good

Updated 9 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 accident and emergency (A&E) attendances. Immunisation rates were relatively high 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, and we saw evidence to confirm this.

  • A full range of family planning services were provided and sexual health support for young people was offered, including chlamydia screening.

  • Uptake for the cervical screening programme was 87%, which was higher than the CCG average of 85% and the national average of 81%.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • We saw positive examples of joint working with midwives and health visitors.

Older people

Good

Updated 9 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.

  • Health checks were offered to those over 75 years of age and patients on multiple medications were regularly reviewed by the pharmacist.

Working age people (including those recently retired and students)

Good

Updated 9 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 it offered to ensure these were accessible, flexible and offered continuity of care. For example, appointments outside of the standard working day and telephone consultations were available.

  • The practice was proactive in offering online services including appointment booking as well as a full range of health promotion and screening that reflects the needs for this age group. For example, a health check for patients over 40 years of age was offered by the provider.

People experiencing poor mental health (including people with dementia)

Good

Updated 9 February 2017

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

  • 89% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was 5% higher than the national average.
  • 100% of eligible patients experiencing a serious mental illness had an up to date care plan. This was 11% higher than the national average. However, the practice reported an exception rate of 38%, which was significantly higher than the national exception rate of 13%. The practice told us the rate was being reduced by a review of patient coding by a newly appointed dedicated staff member and a programme of follow-up review by a GP.

  • 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, voluntary organisations and secondary medical services. For example, the practice actively referred eligible patients to appropriate therapeutic services such as IAPT (Improving Access to Psychological Treatments).

  • The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

  • 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 9 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.

  • Patients who were known to be vulnerable were followed up by the practice if they missed an appointment.

  • The practice offered longer appointments for patients with a learning disability and undertook annual reviews.

  • The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example; the practice liaised regularly with a local provider that provided care for a group of patients with a learning disability.

  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations.