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Archived: Clapham Junction Medical Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 9 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Clapham Junction Medical Practice on 2 June 2016. The overall rating for the practice was good; however for people experiencing poor mental health (including people with dementia) and people with long term conditions, the rating in the effective domain was requires improvement. Consequently, the effective domain overall was rated requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Clapham Junction Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 23 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 2 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • Performance for diabetes related indicators had improved and was comparable to the local and national averages.

  • Performance for mental health related indicators was comparable to the local and national averages and exception reporting rates had improved to below local and national averages.

We also reviewed the areas we identified where the provider should make improvement:

  • The practice had undertaken infection control audits and had recorded actions taken to address identified issues including supplying a separate fridge for patient specimens that required refrigeration.

  • Health and Safety risk assessments showed action had been taken to ensure cleaning chemicals were safely stored and safety information readily available for them.

  • The practice provided us with evidence of fire risk assessments carried out for both sites and we saw evidence of fire alarm testing, and testing to ensure electrical appliances were safe to use.  

  • The accessibility and facilities available at each site had been reviewed and signs put up advertising the availability of areas for breast feeding and private conversations. The practice had also consulted with patients and the local clinical commissioning group about the improvements required to facilities and accessibility and had decided to close their Lavender Hill site.

  • The practice had reviewed and updated their business continuity plan to include staff contact details.

However, there were also areas of practice where the provider should make improvements: 

  • Continue to review and develop ways of improving outcomes for patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 9 May 2017

Effective

Good

Updated 9 May 2017

Following our June 2016 inspection, the practice put in place a number of measures to improve outcomes for patients with long term conditions and people experiencing poor mental health (Including people with dementia) including;

  • Employing an IT administrator to improve computer system coding across all patient groups to ensure effective recording of patient reviews and outcomes submitted to the quality and outcomes framework (QOF) programme.
  • Regular reviews of QOF performance by the lead GP and IT administrator/coder to identify areas where the practice is underperforming, and review the relevant patient list and booking review appointments with the practice nurse and/or GP as appropriate.
  • Enlisting help from the community diabetic nurse specialist to provide joint clinics with the practice nurse once a month reviewing patients with poorly controlled diabetes.

Data from 2015/2016 showed:

  • Performance for diabetes related indicators had improved and was comparable to the local and national averages.
  • Performance for mental health related indicators was comparable to the local and national averages and exception reporting rates had improved to below local and national averages.

The practice also provided us with up to date QOF performance data for 2016/17 which demonstrated that the practice were on target to achieve local and national targets for QOF; however, this data had not yet been submitted for 2016/17 and therefore was unverified and could change.

Caring

Good

Updated 9 May 2017

Responsive

Good

Updated 9 May 2017

Well-led

Good

Updated 9 May 2017

Checks on specific services

People with long term conditions

Good

Updated 9 May 2017

The provider had resolved the concerns for effective identified at our inspection on 2 June 2016 which applied to this population group. The population group rating has been updated to reflect this.

Families, children and young people

Good

Updated 21 September 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 Accident and Emergency 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 80%, which was comparable to the Clinical Commissioning Group average of 81% and the national average of 82%.

  • Appointments were available outside of school hours and the premises were suitable for children and babies, however baby change facilities were not available at the Lavender Hill site.

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

Older people

Good

Updated 21 September 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.

  • All of the patients in this population group had a named GP responsible for their care.

Working age people (including those recently retired and students)

Good

Updated 21 September 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 offered telephone consultations for patients who could not attend during working hours.

People experiencing poor mental health (including people with dementia)

Good

Updated 9 May 2017

The provider had resolved the concerns for effective identified at our inspection on 2 June 2016 which applied to this population group. The population group rating has been updated to reflect this.

People whose circumstances may make them vulnerable

Good

Updated 21 September 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 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.