Archived: Marlborough Street Surgery

Updated 9 April 2015

Marlborough Street Surgery at 1 Marlborough Street, Devonport, Plymouth PL1 4AE provides primary medical services to people living in the Devonport area in the city of Plymouth, Devon and there is also a branch surgery called Glendower in the area of Peverell in the city. Both practices provide services to a diverse population and age group.

At the time of our inspection there were approximately 5,000 patients registered at the Marlborough Street practice and approximately 1,000 patients at the Glendower surgery. Both practices share the same staff and patients can visit either practice. There were two full time male GP partners that held managerial and financial responsibility for running the business and worked full time. In addition there was two female salaried GPs who worked part time. The GPs were supported by two registered nurses, two healthcare assistants, a practice manager, and additional administrative and reception staff.

Patients using the practice also have access to community staff including district nurses, health visitors, and midwives.

Marlborough Street practice is open from 8am until 6pm Monday to Friday and Glendower practice from 8:30am to 6pm each week day except Tuesday when the practice closes at 1pm. A late evening surgery is available at Marlborough Street two evenings a week for patients that find it difficult to visit the GP during the day. Patients could visit either practice. At weekends and when the surgery is closed, patients are directed to an Out of Hours service delivered by another provider.

Both practices are located in older buildings. The practice are in the process of starting a new build nearby.

Updated 9 April 2015

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Marlborough Street Surgery on 15 October 2014. Marlborough Street Surgery at 1 Marlborough Street, Devonport Plymouth PL1 4AE provides primary medical services to people living in the Devonport area in the city of Plymouth, Devon and there is also a branch surgery called Glendower in the Peverell area of the city. Both practices provide services to a diverse population and age group.

The practice was rated as Requiring Improvement

Our key findings were as follows:

Patient feedback from surveys, comment cards and verbal feedback was overall positive. The majority of patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. The practice enabled patients to book appointments quickly.

There were concerns regarding the monitoring of infection control and staff knowledge of safeguarding adults and children. GPs had received safeguarding training at the appropriate level. Training was not monitored adequately and some staff did not receive all the training they needed to help them provide safe and effective care.

The practice undertook audits and reviewed any serious incidents that occurred, however we could not see evidence that all staff were made aware of any changes that had been made to improve the service.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• All staff, according to their job role, must receive training updated training in safeguarding vulnerable adults and children.
• If reception staff are used as chaperones they must have received training to undertake this role.

In addition the provider should:

Clinical Governance meetings should be held more frequently and a means of relaying any discussion and/or remedial actions to all staff should be introduced and formalised.

A risk assessment regarding Legionella testing should be carried out.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 April 2015

The practice is rated as good for the care of 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 for specific conditions such as diabetes and asthma. Although the practice did not provide named GPs for patients with chronic medical conditions, patients felt well cared for and said they could access appointments at the practice easily. Longer appointments were available for patients if required, particularly for those with long term conditions.

Updated 9 April 2015

The practice is rated as good for the care of families, children and young people. Staff worked well with the midwife and health visitor, who were based away from the practice, to provide prenatal and postnatal care. The practice achievement for baby and child immunisations matched the regional average.

Information relevant to young patients was displayed and health checks and advice on sexual health were provided. Chlamydia screening kits were available for young patients to take away with them.

Updated 9 April 2015

The practice is rated as good for the care of older patients. The practice provided good quality care to older patients. Patients over 75 years old had a named GP to provide continuity in care. Health checks and promotion of healthy lifestyles were encouraged and offered to this group of patients. Pneumococcal vaccination and shingles vaccinations were provided at the practice for older patients during routine appointments or by arrangements with the healthcare workers. GPs undertook home visits for older patients who lived in local care homes or who were housebound and had difficulty visiting the practice.

Updated 9 April 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The practice provided appointments on the same day, although appointments could be booked up to a month in advance. The practice operated extended opening hours on Mondays and Wednesdays for emergencies or pre booked appointments. Appointments could be made either in person or by telephone. Patients generally reported that they could access appointments. Telephone consultations were available for patients, which benefitted those who worked during surgery hours.

Updated 9 April 2015

The practice is rated as good for the care of patients experiencing poor mental health (including people with dementia). Patients with mental health care needs were registered at the practice. Some patients with mental health needs had regular appointments with the practice nurse to help them manage their medicines. There was signposting and information available to patients, for example a counselling service.

The practice referred patients who needed mental health services to the local mental health team. The practice had recognised the need for patients who experience poor mental health to see a GP urgently and had changed it’s appointment system to allow for same day appointments. Monitoring of medicines dispensed by the practice was undertaken in way that protected patients from the risk of inappropriate use of medicines.

Updated 9 April 2015

The practice was rated as requires improvement for the care of people whose circumstances may make them vulnerable. People wishing to register at the practice were always accepted. Home visits were provided to patients with mobility difficulties. Interpreters were used for patients who did not speak English. Not all of the staff had not received adequate training in safeguarding adults and children. GPs had training in the Mental Capacity Act (MCA) 2005 but healthcare assistants other staff did not have an adequate understanding or appropriate guidance available in relation to the MCA. This could affect the rights of patients who may lack capacity to make decisions about their care or treatment. Patients with a learning disability were in the process of being offered an annual health check at the practice, but this had not been fully instigated.