Archived: Kidgate Surgery

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced focussed follow up inspection on 19 December 2016 to follow up on concerns we found at Kidgate Surgery on 7 July 2016. The inspection in December 2016 was to ensure that improvement had been made following our inspection in July 2016 when breaches of regulations had been identified. The inspection in July 2016 found breaches of regulation and rated the practice as requires improvement in safe services. However the practice was rated as good overall.

At the inspection on 19 December 2016 we found that overall the practice had implemented changes and that the service was meeting the requirements of the regulations. The ratings for the practice have been updated to reflect our findings following the improvements made since our last inspection in July 2016. The practice was therefore rated as good for providing safe services.

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

• The practice had applied for DBS for all staff. The majority of these had come through however there were still three checks outstanding although we saw evidence that these had been applied for.

• Emergency medicines included all those recommended for all activities carried out by the practice, specifically atropine for emergency treatment if required, during the fitting of contraceptive coils or minor surgery.

• Handling of blank prescription forms reflected nationally accepted guidance as detailed in NHS Protect Security of prescription forms guidance.

• The practice had written consent process and patient satisfaction feedback in place for minor surgery where more invasive procedures i.e. excisions occurred.

• There was adequate levels of security in relation to access to the dispensary.

The areas where the provider should make improvements are:

• Ensure that the patient participation is active and feedback from patients is sought

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 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 83% which was worse than the CCG average of 89% and the national average of 90%.
• The practice have commenced GP and nursing led clinics for diabetic patients in 2016.

• Longer appointments and home visits were available when needed.

• All these 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 25 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 78%, which was comparable to the CCG average of 83% and the national average of 82%.

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

• We saw positive examples of joint working with midwives and health visitors.

Updated 25 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.

• The practice were linked to care homes in the area were they had patients residing at and worked closely with the care home staff to provide reviews and home visits where necessary.

Updated 25 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 8pm on Monday evenings for patients that were unable to attend during the day.

Updated 25 August 2016

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

• 97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.

• 93% of patients with mental or physical health conditions alcohol consumption recorded, compared to the national average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice referred patients to the community mental health team and also referred to local support groups such as Dementia Café drop in centre.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 25 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 had identified that this was an area that could be developed and had discussed future plans with the practice nurse to lead on.

• 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.

• 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.