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University of Sussex Health Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 14 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Health Centre University of Sussex on 11 October 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained 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 and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they were able to make an appointment with a GP and there was continuity of care, with a popular urgent appointments system 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.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The practice worked regularly with the university student support unit to care for students who required extra support and care.

  • Alcohol screening was completed for all new registrations, and offered on a regular basis to all patients.

  • The practice had a care protocol for supporting patients with drug problems and referred them to the local substance misuse support service.

  • The GPs and nursing team provided nurture and support to patients and guided them in making decisions about their health during the first time away from the family home when they might feelisolated from parental guidance.

The area where the provider should make improvement is:

  • Establish a system to monitor the overall trends in significant events to help prevent them from happening in the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 December 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events. However the practice did not have a system in place to monitor the overall trends in significant events to help prevent them from happening in the future.

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed.

Effective

Good

Updated 14 December 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) which were relevant to the patient population showed patient outcomes were at or above average compared to the national average.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 14 December 2016

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.

  • 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 staff treated patients with kindness and respect, and maintained patient and information confidentiality.

  • The GPs and nursing team provided nurture and support to patients. They guided them in making decisions about their health during the first time away from the family home when they may feel isolated from parental guidance.

Responsive

Good

Updated 14 December 2016

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England area team and clinical commissioning group to secure improvements to services where these were identified.

  • The practice had a significant number of temporarily registered and transitional patients and registered over 2200 new patients each October with each intake of students at the university.

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

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • The practice had created population specific treatment protocols which were available on the computer system. This helped clinicians to give thorough and appropriate assessment and treatment.

  • 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 14 December 2016

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.

  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.

    The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken

  • The practice proactively sought feedback from staff and patients, which it acted on. The patient reference group was active.

  • There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions

Good

Updated 14 December 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 asthma related indicators was in line with the clinical commissioning group (CCG) and national averages. For example, the percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months was 81% compared to the CCG average of 71% and the national average of 76%.

  • Longer appointments and home visits or transport to attend the practice 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.

Families, children and young people

Good

Updated 14 December 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.

  • 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.

  • 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.

  • The practice worked jointly with the local family and children centre to provide support for families.

Older people

Good

Updated 14 December 2016

  • Patients over 65 years of age made up only 0.3% of the practice population. This was well below the clinical commissioning group (CCG) average of 13% and the national average of 17%.

  • The practice offered proactive, personalised care to meet the needs of the small number of older people in its population.

  • The practice was responsive to the needs of older people. The practice offered home visits for patient who were housebound, transport to attend the practice for those who were unable to attend and urgent appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 14 December 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

  • The needs of the student population 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 offered text reminders to patients who booked their appointments online.

  • There were notice boards with information relevant to young people such as sexual health, mental health, healthy eating, sexual orientation and gender identity issues, information about local social groups, alcohol and drug awareness and support groups.

  • Sexual health screening kits were available to patients.

  • Alcohol screening was completed for all new registrations, and offered on a regular basis to all patients.

  • The practice had a care protocol for supporting patients with drug problems and referred them to the local substance misuse support service.

  • There was an on-site ‘sick room’ which was used regularly for patients living at the university who presented with acute symptoms but did not require hospital admission. This reduced the number of inappropriate attendees at the accident and emergency department and patients were cared for by the nursing team.

  • The practice worked regularly with the university student support unit to care for students who required extra support and care.

  • The GPs and nursing team provided nurture and support to patients and guided them in making decisions about their health during the first time away from the family home when they may feel otherwise isolated from parental guidance.

People experiencing poor mental health (including people with dementia)

Good

Updated 14 December 2016

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

  • The practice results for the management of patients with poor mental health was in line with the local and national averages. For example, 86% of their patients with severe and enduring mental health problems had a comprehensive care plan documented in their records within the last 12 months compared to the CCG average of 76% and the national average of 89%.

  • 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 told patients experiencing poor mental health how to access various support groups and voluntary organisations. Information about the support available was displayed in the waiting room on posters and in leaflets.

  • 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.

  • The practice offered dementia screening and referral to the local memory assessment clinic and carried out advance care planning for those diagnosed with dementia.

  • The practice were able to refer patients to the university counselling service.

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

People whose circumstances may make them vulnerable

Good

Updated 14 December 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 and travellers.

  • 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.