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Red Roofs Practitioners Good

Inspection Summary


Overall summary & rating

Good

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Red Roofs Surgery on 24 November 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well led services.

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

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice worked closely with other local practices and acute providers such as Nuneaton’s George Eliot hospital.

  • Patients said they found it easy to make an appointment with a named GP, that there was continuity of care, and urgent appointments were usually available the same day.

  • Staff had received training appropriate to their roles and any further training needs had been identified and planned. Staff training was also linked to the staff appraisal scheme to ensure staff were fully developed to best meet the needs of patients.

  • Risks to patients were assessed and well managed with appropriate systems in place.

  • The practice had good facilities and was well equipped to treat patients and meet their needs. A building refurbishment was taking place.

  • There was a clearly defined leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 25 February 2016

The practice is rated as good for providing safe services. Staff understood their responsibilities to raise concerns, and they identified and reported incidents and near misses. Learning points were identified and communicated widely amongst staff to support improvement. Information about safety was recorded, monitored, reviewed and addressed. Risks to patients were assessed and well managed. Appropriate safeguarding measures were in place to help protect children and vulnerable adults from the risk of abuse. This included regular staff meetings to review safeguarding cases. There were enough staff to keep people safe. The practice worked closely with local care homes where patients lived to ensure procedures covered by the Mental Capacity Act were correctly followed.

Effective

Good

Updated 25 February 2016

The practice is rated as good for providing effective services. Staff referred to guidance from the National Institute for Health and Care Excellence (NICE) and used it routinely.

Patients’ needs were assessed and care was planned and delivered in line with current legislation. Staff had received training appropriate to their roles and any additional training needs were identified and planned to meet these needs. Staff were appraised annually and had personal development plans in place. Staff worked with multidisciplinary teams to improve outcomes for patients.

Caring

Good

Updated 25 February 2016

The practice is rated as good for providing caring services. 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. We saw that staff treated patients with kindness and respect, and maintained confidentiality. They had a register of patients who were carers and at the time of our inspection the practice had started to set up a support group for carers.

Responsive

Good

Updated 25 February 2016

The practice is rated as good for providing responsive services. It identified and reviewed the needs of its local population and engaged with the NHS England Area Team and the Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. Patients said they were able to make an appointment with a GP and were able to obtain urgent appointments the same day. Extended hours opening was available on Saturday mornings.

The practice building was purpose built and well equipped to treat patients and meet their needs. At the time of our inspection the practice had plans approved to extend the practice facilities into rooms that had previously been commercially sub-let to meet increased patient demand. Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 25 February 2016

The practice is rated as good for being well-led. It had a clear vision and strategy. Staff were clear about the vision and their responsibilities in relation to this. There was a clear leadership structure with a succession plan in place. Staff felt supported by management. The practice had policies and procedures to govern management and held regular governance meetings. Appropriate systems were in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients, which it acted on. The practice had a long established, active patient participation group and responded to feedback from patients about ways that improvements could be made to the services offered. Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

People with long term conditions

Good

Updated 25 February 2016

The practice is rated as good for the care of people with long-term conditions. The practice used a chronic disease management system to monitor patients with chronic diseases. Management of patients with long term conditions was carried out by the practice nursing team and healthcare assistant. Patients at risk of hospital admission were closely monitored. Longer appointments and home visits were available when needed. Patients were reviewed at least annually, sometimes more frequently depending on the condition they had and its severity. All patients diagnosed with a long term condition had a structured annual review to check that their health and medicine needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice also offered dietary, weight management and smoking cessation advice. All members of practice staff and the Patient Participation Group (PPG) had received dementia friends training to enable them to provide a higher level of support to patients with dementia.

Families, children and young people

Good

Updated 25 February 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 of abuse. For example, children and young people who had a high number of accident and emergency (A&E) attendances.

The practice ran baby clinics and post-natal appointments. The practice had a policy providing same day appointments for children and appointments were also available outside of school hours. The premises were suitable and accessible for children, with changing facilities for babies. We saw good examples of joint working with midwives, health visitors, school nurses and district nurses. The practice notified Child Health Services when babies and children did not attend for their vaccinations.

The practice also offered a number of online services including booking appointments and requesting repeat medicines.

Older people

Good

Updated 25 February 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits for those unable to reach the practice. A weekly ‘ward round’ was carried out in the eight care homes the practice had patients living in. The practice had also worked closely with these care homes to ensure procedures covered by the Mental Capacity Act were correctly followed.

At the time of our inspection, the practice was delivering its 2015-2016 flu vaccination programme. The practice worked closely with the local risk stratification enhanced service to closely monitor patients most at risk. This included those most at risk of unplanned hospital admission. The practice staff held weekly meetings to review hospital admissions and accident and emergency attendances and had developed a computerised tracker to record outcomes and identify trends.

Working age people (including those recently retired and students)

Good

Updated 25 February 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. Telephone consultations were available for patients who were unable to reach the practice during the day. Extended hours opening was available on Saturday mornings for patients who worked during the week. The practice was proactive in offering online services as well as a full range of health promotion and screening services that reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 25 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams to plan care and treatment with patients who experienced poor mental health, including those with dementia. It carried out advanced care planning and annual health checks for patients with dementia and poor mental health. The clinical team understood the importance of considering patients’ ability to consent to care and treatment and dealt with this in accordance with the requirements of the Mental Capacity Act 2005.

The practice had advised patients experiencing poor mental health 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). 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 25 February 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 patients with a learning disability. For example, the practice had carried out annual health checks and offered longer appointments for patients with a learning disability. Members of the traveller and gypsy communities were also able to register at the practice.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had advised vulnerable patients on how to access various support groups and voluntary organisations. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments and offered additional attention such as longer appointments. The practice staff held weekly meetings to review hospital admissions and accident and emergency attendances and had developed a computerised tracker to record outcomes and identify trends.

Staff had received training and knew how to recognise signs of abuse in adults whose circumstances made them vulnerable and children who were considered to be at risk of harm. 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.

A GP partner had training and experience with working with a drug and alcohol service and a scheme for violent and aggressive patients. As a result, the practice was able to meet the needs of patients within these categories and provide additional support when needed.