Lisson Grove and Woolwell Medical Centres

Updated 6 August 2015

The Lisson Grove Surgery provides primary medical services to people living in the Mutley area of Plymouth. They also had a branch medical centre in Woolwell which is located on the outskirts of Plymouth. The staff work across both sites and patients are able to be seen at either practice. We did not inspect the Woolwell branch on this inspection.

At the time of our inspection there were approximately 9,100 patients registered at The Lisson Grove Surgery. There were three GP partners, two female and one male, who held managerial and financial responsibility for running the business. There was also two male GPs, currently working within the practices joining as partners on 1 July 2015. The GPs were supported by a Nurse practitioner, four registered nurses, and two healthcare assistant, a practice manager, and additional administrative and reception staff. Patients using the practice also had access to community staff including district nurses, health visitors, and midwives.

The Lisson Grove Surgery is open from 8 am until 1pm and then 2pm until 6pm Monday to Friday. Appointments are available from 8am to 1pm and then from 2pm until 6pm. During evenings and weekends, when the practice is closed, patients are directed to an Out of Hours service delivered by another provider.

The Practice is actively involved in teaching medical students from the Peninsular Medical School and is also a GP training Practice.

The practice had a general medical service contract that outlined core services to be provided to patients. The practice had not signed up for the provision of enabling patients to consult a health care professional, face to face, by telephone or by other means at times other than during core hours.

Updated 6 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Lisson Grove Surgery on 23 June 2015.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for the population groups of older people; people with long term conditions; families, young people and children; people experiencing poor mental health; people in vulnerable circumstances; working age people and those recently retired.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.

• Patients said they found it easy to make an appointment with a named GP and that 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.

However there were areas of practice where the provider needs to make improvements

Importantly the provider should

• Ensure that staff undertaking chaperone duties should receive training in this role.

Ensure that patients are aware of the chaperone service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 August 2015

The practice is rated as good for providing care to people with long term conditions.

The practice managed the care and treatment for patients with long term conditions in line with best practice and national guidance. Health promotion and health checks were offered to patient with specific conditions, such as diabetes and asthma. Practice nurses did not have separate clinics for patients with long-term conditions but run mixed clinics with varying appointment times, allowing greater flexibility.

The practice had a carers' register and all carers were offered an appointment for a carers' check with nursing staff. The practice worked with other health professionals to help patients stay within their own homes and avoid hospital admission where possible.

Updated 6 August 2015

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

Staff worked well with the midwife to provide antenatal and postnatal care. The practice provided baby and child immunisation programmes to ensure babies and children could access a full range of vaccinations and health screening. Patients could book appointments online and these were available before and after school hours. Patients were sent a text reminding them of their appointment.

Information relevant to young patients was displayed and health checks and advice on sexual health for men, women and young people included a full range of contraception services and sexual health screening including chlamydia testing and cervical screening. The GPs training in safeguarding children from abuse was at the required level three.

Updated 6 August 2015

The practice is rated as good for providing care to older people.

All patients over 75 years had a named GP. Health checks and promotion were offered to this group of patients. There were safeguards in place to identify adults in vulnerable circumstances. Each of the 11 local care homes had a named GP.

The practice worked well with external professionals in delivering care to older patients, including end of life care. The practice worked with other community staff to help patients stay within their own homes and avoid hospital admission where possible.

Pneumococcal vaccination and shingles vaccinations were provided at the practice for older people on set days as well as during routine appointments. A nurse visited a local care home to administer flu and shingles vaccinations. Patients could obtain their medicines from a local pharmacy.

Updated 6 August 2015

The practice is rated as good for providing care to working age people.

The practice provided appointments or telephone consultation on the same day. Emergency appointments were available. The practice operated early opening and extended hours each day.

Smoking cessation and lifestyle consultations and appointments were available. The practice website invited all patients aged between 40 years to 75 years to arrange to have a health check with a nurse if they wanted. A cervical screening service was available. Patients could order repeat prescriptions on line.

Updated 6 August 2015

The practice is rated as good for people experiencing poor mental health, including people with dementia.

The practice was aware of their ageing patient population group, particularly in relation to those with dementia. Staff were aware of the safeguarding principles and GPs and nurses had access to safeguarding policies. All staff had received training in the Mental Capacity Act (MCA) 2005 and were aware of the principles and used them when gaining consent. The practice worked closely with the primary care dementia support practitioner and district nurses to help patients retain enough independence to remain at home. There was signposting and information available to patients.

The practice referred patients who needed mental health services and community psychiatric nurses visited the practice. Support services for patients with depression were provided at the practice, such as counselling. Patients suffering poor mental health were offered annual health checks as recommended by national guidelines.

Updated 6 August 2015

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

The practice had a vulnerable patient register to identify these patients. Vulnerable patients had their cases reviewed at team meetings. Referral to a counselling service was available. The practice did not provide primary care services for patients who were homeless as none were known, however, staff said they would not turn away a patient if they needed primary care and could not access it.

Patients with language interpretation requirements were known to the practice and staff knew how to access translation services. A portable computer device was available at reception for interpreter purposes.

Patients with learning disabilities were offered a health check every year during which their long term care plans were discussed with them and their carer if appropriate. Reception staff were able to identify vulnerable patients and offer longer appointment times where needed.

The practice provided services for patients on the violent patient register; this ensured that there were sufficient arrangements in place to provide primary medical services to patients who have been subject to immediate removal from a patient list of a primary medical services contractor because of an act or threat of violence.