Rosemary Street Health Centre

Updated 15 August 2016

Rosemary Street Health Centre is situated on one of the main roads on the outskirts of Mansfield Town Centre close to many comprehensive and Junior schools and a large supermarket. The practice has a branch site at Oak Tree Lane Surgery which is situated to the southeast of Mansfield town centre. Full Services are provided at both sites and all patients, staff and partners attend both sites.

Rosemary Street Health Centre is one of the practices within Mansfield and Ashfield Clinical Commissioning Group and provides general medical services to approximately 14200 registered patients.

The practice is equipped for patients that are disabled or have limited mobility and has good public transport links.

All services are provided from:

Rosemary Street Health Centre, Rosemary Street, Mansfield, Nottinghamshire, NG19 6AB and

Oak Tree Lane Surgery, Jubilee Way South, Mansfield, NG18 3SF.

The branch was not visited on the day of the inspection.

• The practice comprises of three GP Partners (male) and two salaried GPs.

• The nursing team consists of two advanced nurse practitioners (ANP’s), three nurse practitioners (NP’s), two practice nurses and four health care assistants (HCA’s).

• This practice provides training for doctors who wish to become GPs and at the time of the inspection had two doctors undertaking training at the practice. (Teaching practices take medical students and training practices have GP trainees and F2 doctors).

• A practice manager and a team of 18 reception and administrative staff undertake the day to day management and running of the practice.

• The practice is in the third most deprived decile meaning that it has a higher proportion of people living there who are classed as deprived than most areas

• The practice has core opening hours from 8am every weekday and closes at 7.15pm other than Tuesday 7.30pm and Friday 7pm. The practice also offer extended hours alternate Saturdays 9am til 2pm for bookable appointments.

• There are appointments that can be booked on the day or in advance with GPs or a member of the nursing team.

• The practice opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website, on the practice door and over the telephone when the surgery is closed.

Updated 15 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rosemary Street Health Centre on 14 July 2016. 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 an effective system in place for reporting and recording significant events.
• 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 on the day although if they requested a particular GP there would be a wait for an appointment of up to three weeks.
• Care home staff said that they found it difficult to get through on the telephone and that staff were sometimes busy to answer their queries.
• Patients were positive about the care and treatment received. The practice was rated in line with national and local averages in almost all the national survey questions.
• The practice facilities were well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice sought feedback from patients and the patient participation group were active.
• Blank prescription forms and pads were securely stored but there were no systems in place to monitor their use, however this was rectified at the inspection and the practice then produced a policy and procedure the day after the inspection.
• References, qualifications and registration with the appropriate professional body had been completed however the appropriate checks through the Disclosure and Barring Service had not been completed for all administration staff. On the day of the inspection there were no risk assessments in place, however these were produced the following day.
• Risks to patients were assessed however risk assessments were overdue for review at the time of the inspection.

The areas where the provider should make improvements are:

• Make sure that the recruitment process includes risk assessments in relation to DBS checks.

• Ensure that risk assessments at the practice are reviewed regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 August 2016

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.

• Performance for diabetes related indicators was 95% which was better than the CCG average of 82% and the national average of 90%.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and 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.

Updated 15 August 2016

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 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.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 85% and the national average of 82%.

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

• We saw examples of joint working with midwives and health visitors who were invited to the weekly clinical meetings.

Updated 15 August 2016

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.

• Influenza, pneumococcal and shingles vaccinations were offered (where necessary) in accordance with national guidance.

• Monthly multi-disciplinary care meetings were held to avoid hospital admission and ensure integrated care for older people with complex health care needs.

Updated 15 August 2016

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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice had appointments to up to 7.30pm midweek and opened on alternate Saturday mornings from 9am til 2pm.

Updated 15 August 2016

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

• 84 % of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is in line with the national average of 84%.
• 69% of patients with mental or physical health conditions had a comprehensive care plan documented in the record, in the preceding 12 months, compared to the national average of 88%. The practice had identified all mental health patients registered so that they could organise reviews and correct any coding errors if applicable.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• Patients experiencing poor mental health could access a range of information on support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 August 2016

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 those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

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

• The practice worked with other agencies in looking at ways to support those patients that suffered from domestic abuse.

• 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.