Archived: Dr R M Hall and Partners, Kennington Health Centre

Updated 4 October 2016

We undertook an inspection of this practice on 13 September 2016. The practice provides services from Dr R M Hall and Partners, Kennington Health Centre, 200 Kennington Road, Oxford, Oxfordshire, OX1 5PY.

Dr R M Hall and Partners, also known as Kennington Health Centre has a purpose built location with good accessibility to all its consultation rooms. The practice serves 6,700 patients from the surrounding town and villages. The practice demographics show that the population has a much higher proportion of patients over 65 compared to the national average and much lower prevalence of younger patients. According to national data there is minimal deprivation among the local population. There are patients from minority ethnic backgrounds, but this is a small proportion of the practice population. The practice had been trying to recruit more GPs for some time prior to the inspection. The partners had altered the service to maintain and improve services despite having a lower number of GPs than desired.

• There are four GP partners and one salaried GP working at the practice, including four females and one male. There are two practice nurses and a healthcare assistant. A number of administrative staff and a practice manager support the clinical team.
• There are four whole time equivalent (WTE) GPs, two WTE nurses and one WTE healthcare assistant.

• Dr R M Hall and Partners, Kennington Health Centre is open between 8.30am and 6.30pm Monday to Friday. There are extended hours appointments available from Monday to Thursday up to 7.15pm.
• Out of hours GP services were available when the practice was closed by phoning 111 and this was advertised on the practice website.
• This is a training practice.

The practice was inspected in 2013 under our previous methodology and a follow up inspection took place in 2014 as a result of a breach of regulations. At the last inspection the practice was found to be meeting requirements related to regulations.

Updated 4 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr R M Hall and Partners, Kennington Health Centre on 13 September 2016. Overall the practice is rated as good.

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

• There was a system in place for reporting and recording significant events. Reviews of complaints, incidents and other learning events were thorough.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ ongoing needs and delivered care in line with current evidence based guidance.
• National data suggested patients received appropriate care for long term conditions.
• The practice planned its services based on the needs and demographic of its patient population.
• Staff were trained in order 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patient feedback in CQC comment cards suggested patients felt staff were caring and considerate.
• 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.
• There was a strong ethos of continuous learning and improvement.

Areas the provide should make improvements are:

• Review the training and guidance related to prioritising patients when calling to request appointments available to reception staff, to ensure that urgent needs are identified wherever possible.
• Continue to improve the recording of patient medicine reviews to ensure this system can be monitored and that patients are receiving timely reviews.
• Ensure disposable curtains are changed in line with their expiry dates.
• Consider providing a hearing loop to support patients with hearing difficulties.
• Review patient feedback regarding their satisfaction with the practice, particularly in monitoring the new appointment system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 October 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 had appropriate training.
• Patients at risk of hospital admission were identified as a priority.
• The most recent published results of national care data showed the practice was performing well compared to the clinical commissioning group (CCG) averages.
• The number of up to date medicine reviews was a concern due to low a proportion of completed reviews recorded on the system. However, the practice had identified this concern and had an action plan to ensure there were no immediate risks and improve recording long term.
• All these patients were offered 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 4 October 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 similar to average for all standard childhood immunisations.
• Staff explained how they treated children and young people in an age-appropriate way including recognition of their rights to access treatment.
• We saw positive examples of joint working with midwives and health visitors.
• Joint working with external organisations took place in the management of children at risk of abuse.
• The practice’s uptake for the cervical screening programme was 79%, which was similar to the national average of 82%.
• GPs provided surgeries at a local boarding school twice a week.

Updated 4 October 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 high proportion of older people in its population.
• GPs offered personalised care to patients in care and nursing homes.
• The premises were accessible for patients with limited mobility. There was no hearing loop available to support patients who had difficulties with their hearing.
• Patients over 75 had a named GP.
• Care planning was provided for patients with dementia.
• The practice achieved high rates of flu vaccinations.

Updated 4 October 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 considered and the practice had adjusted the services it offered enable continuity of care.
• Patients’ feedback on the appointment system had been responded to by introducing a new appointment system.
• The appointment system was monitored to identify improvements where possible.
• 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.
• Travel vaccinations were available.
• There were extended hours appointments available.

Updated 4 October 2016

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

• Performance for mental health related indicators was 100% compared to the national average 92% and regional average of 95%.
• The proportion of patients on mental health register with care plan and up to date physical assessment was 81%.
• 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 advanced care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 4 October 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 homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for vulnerable patients.
• Learning disability health checks were offered and 80% of patients registered as eligible for a check had one in 2015/16.
• 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.
• 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.
• Joint working with external organisations took place in the management of patients at risk of abuse or harm.