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Dr Moore and Partners Good Also known as Stoke Road Surgery

Inspection Summary


Overall summary & rating

Good

Updated 31 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Moore and Partners on 7 July 2016. Overall the practice was rated as good. We found the practice to be requires improvement for providing safe services, and good for providing effective, caring, responsive and well led services. The full comprehensive report on the 7 July 2016 inspection can be found by selecting the ‘all reports’ link for Dr Moore and Partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 22 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection on 7 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe services. Overall the practice remains rated as good.

Our key findings were as follows:

  • The practice had reviewed its recruitment process to ensure all information in relation to staff employment was available, including proof of identity for staff.

  • The practice had engaged an external contractor to carry out a legionella risk assessment. Legionella is a term for particular bacteria which can contaminate water systems in buildings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 31 August 2017

At the last comprehensive inspection on the 7 July 2016, we found that the practice was not meeting legal requirements for providing safe services. Since our last inspection, the practice had made a number of improvements to address the breaches in regulations we previously identified.

Specifically, the practice had:

  • Engaged an external contractor to carry out a legionella risk assessment, following extensive refurbishment to the premises. Legionella is a term for particular bacteria which can contaminate water systems in buildings.

  • Reviewed its recruitment process to ensure all information in relation to staff employment was available, including proof of identity for staff.

Effective

Good

Updated 31 August 2017

Caring

Good

Updated 31 August 2017

Responsive

Good

Updated 31 August 2017

Well-led

Good

Updated 31 August 2017

Checks on specific services

People with long term conditions

Good

Updated 6 September 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. Patients had care plans to help avoid unplanned admissions.

  • Longer appointments and home visits were available when needed.

  • All patients with long-term conditions 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. Patients with more than one long-term condition could have all their annual reviews done in one visit, rather than having to come separately to various appointments.

  • The practice worked together and with other health care professionals to review and support patients, for example, a chronic obstructive pulmonary disease (COPD) specialist nurse and heart failure nurses.

Families, children and young people

Good

Updated 6 September 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.
  • The practice’s uptake for the cervical screening programme was 84%, which was comparable to the clinical commissioning group (CCG) average of 84% and exceeded the national average of 82%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • Young people could be seen the same day and offered a walk in service on demand, particularly aimed at making sure they could access emergency contraception easily.
  • The practice provided a health education day at the local school in partnership with their patient participation group (PPG).

Older people

Good

Updated 6 September 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 provided two GP visits per week to local nursing homes plus extra visits as requested. Organised dossette/medicines trays for elderly patients with local pharmacies, who delivered to housebound patients.

  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Monthly multi-disciplinary meetings with health and social care professionals were attended by staff to discuss patients at risk of admission to hospital.

  • The practice held a register of patients who were carers, had links with local support groups and the lead receptionist had been trained in offering support for carers.

  • The practice was able to offer Aortic Aneurysm screening (Aortic Aneurysm is a swelling of the aorta which is the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body) on-site through a private provider.

  • The practice’s ‘quick look’ skin clinic was used by older patients, who were a key demographic for skin cancers.

Working age people (including those recently retired and students)

Good

Updated 6 September 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 reflected the needs for this age group. On-line appointment booking and on-line requesting of prescription of medicines was available.
  • Extended hours appointments were offered with GPs and nurses as well as telephone consultations and some limited email communications.
  • Patients were able to sign up for text messaging reminders for appointments.

People experiencing poor mental health (including people with dementia)

Good

Updated 6 September 2016

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

  • The practice maintained a register of patients with diagnosed severe mental health problems and provided annual screening. The practice had a GP with interest in mental health problems and a nurse with special interest in mental health issues who organised their annual health screening. A mental health triage nurse also held clinics once a week at the practice.
  • 98% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
  • 91% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive, agreed care plan documented in the record in the preceding 12 months which was similar to the national average of 88%.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The practice had close links to local services, including the community learning disability team, local psychiatrists and community psychiatric nurses, in order to support these patients. Staff attended care plan meetings where possible with the local mental health team.
  • The practice carried out advance care planning for patients with dementia.
  • The practice provided information for patients experiencing poor mental health about how to access various support groups and voluntary organisations.

People whose circumstances may make them vulnerable

Good

Updated 6 September 2016

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

  • 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 practice held a register of vulnerable patients. Patients’ records included notes on screen to warn clinicians and receptionists that a patient has special needs including communication needs.
  • The practice offered longer appointments for patients in need for example to people with a learning disability.
  • The practice regularly worked with other health care professionals such as district nurses and health visitors in the case management of vulnerable patients. Staff attended multi-disciplinary meetings and met with midwifes and health visitors to discuss concerns. Staff also attended case conferences where possible.
  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
  • Patients in need had unplanned hospital admissions care plans.
  • The practice had a social prescriber available to meet patients and assess their wellbeing needs.