You are here

Bensham Family Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 8 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bensham Family Practice on 28 April 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.
  • Data from the Quality and Outcomes Framework showed most patient outcomes were at or above average for the locality and compared to the national average. (QOF is a system intended to improve the quality of general practice and reward good practice). The practice provided evidence some areas had improved over the last year, including mental health and diabetes care.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
  • Data from the National GP Patient Survey showed patients rated the practice higher than others for several aspects of care.
  • Information about services and how to complain was available and easy to understand.
  • We found there was continuity of care, with urgent appointments 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 they acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

The practice should:

  • continue to not use the branch surgery, which was closed at the time of the inspection, until the health and safety concerns have been addressed or alternative suitable premises arranged.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 8 June 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events
  • Lessons were shared to make sure action was taken to improve safety in the practice.
  • When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and 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 8 June 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were at or above average for the locality and compared to the national average. For 13 of the 19 clinical domains within QOF the practice had achieved 100% of the points available.
  • 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 multidisciplinary teams to understand and meet the range and complexity of patients’ needs. Staff from the extended healthcare team told us multidisciplinary teams meetings were well attended and very well organised.

Caring

Good

Updated 8 June 2016

The practice is rated as good for providing caring services.

  • Data from the National GP Patient Survey showed patients rated the practice broadly in line with local and national averages 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.

Responsive

Good

Updated 8 June 2016

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of their 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 was part of the local initiative to provide primary care navigators within the practice, to signpost patients to local services and organisations to meet their wider health needs.
  • There was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and easy to understand and evidence showed the practice responded to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 8 June 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 this.
  • 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 knowing about 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 they acted on. The patient participation group was small and had not yet generated many ideas as to where the practice could improve.
  • There was a focus on continuous learning and improvement at all levels.
Checks on specific services

People with long term conditions

Good

Updated 8 June 2016

The practice is rated as good for the care of people with long-term conditions.

  • Effective systems were in place, which helped ensure patients with long-term conditions received an appropriate service, which met their needs. These patients all had a named GP and received an annual review to check that their needs were being met. For those people with the most complex needs, the named GP worked with other relevant health and care professionals to deliver a multidisciplinary package of care.
  • 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 better than the CCG and national averages. The practice achieved 100% of the points available. This compared to an average performance of 96.6% across the CCG and 97.4% national average. For example, the percentage of patients on the asthma register who had an asthma review within the preceding 12 months that included an assessment of asthma control was 86.6%, this compared to a national average of 75.4%.
  • Performance for diabetes related indicators was below average for the clinical commissioning group (CCG) and national average. The practice achieved 84.3% of the points available. This compared to an average performance of 92% across the CCG and 89.2% national average. For example, the percent of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 85%, compared to a national average of 88.3%. The practice had plans in place as to how they would address areas of lower performance.
  • Longer appointments and home visits were available when needed.
  • Patients at risk of hospital admission were identified as a priority, and steps were taken to manage their needs.
  • Staff had completed the training they needed to provide patients with safe care.

Families, children and young people

Good

Updated 8 June 2016

The practice is rated as good for the care of families, children and young people.

  • There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. 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. The needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors.
  • Childhood immunisation rates for the vaccinations given were comparable to CCG averages. For example, childhood immunisation rates for the vaccination given to under two year olds ranged from 77.8% to 100% and five year olds from 94% to 98%. The average percentage across the CCG for vaccinations given to under two year olds ranged from 81.3% to 97% and five year olds from 89.8% to 97.9%.
  • 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.
  • Nationally reported data showed the practice had performed in line with average for providing recommended care and treatment for this group of patients.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • We saw good examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 8 June 2016

The practice is rated as good for the care of older people.

  • Staff provided proactive, personalised care, which met the needs of older patients. Patients aged 75 and over were allocated a named GP to help ensure their needs were met.
  • Good arrangements had been made to meet the needs of ‘end of life’ patients. Staff held regular palliative care meetings with other healthcare professionals to review the needs of these patients and ensure they were met.
  • The practice offered home visits and longer appointment times where these were needed by older patients
  • Nationally reported data showed the practice had performed well in providing recommended care and treatment for the clinical conditions commonly associated with this population group.
  • The practice maintained a palliative care register and offered immunisations for pneumonia and shingles to older people.

Working age people (including those recently retired and students)

Good

Updated 8 June 2016

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

  • The practice had assessed the needs of this group of patients and developed their services to help ensure they received a service, which was accessible, flexible and provided 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.
  • Nationally reported data showed the practice provided recommended care and treatment that was in line with or above national averages for this group of patients. For example, the percentage of patients with hypertension in whom the last blood pressure reading measured in the preceding 12 months was 150/90mmHg or less was the higher than the national average. 90.6% of patients had a reading measured within the last nine months, compared to 83.7% nationally.

.

People experiencing poor mental health (including people with dementia)

Good

Updated 8 June 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 in line with, but slightly lower than the CCG and national average. The practice achieved 89.6% of the points available. This compared to an average performance of 92.7% across the CCG and 92.8% national average. For example, 85.7% of patients with schizophrenia, bipolar affective disorder and other psychosis had a comprehensive agreed care plan documented within the preceding 12 months. This compared to a national average of 88.5%. The percentage of patients with schizophrenia, bipolar affective disorder and other psychosis with an alcohol consumption recorded in the preceding 12 months was 76.7%. This compared to an 89.6% national average. The practice provided us with an update on these figures which demonstrated the improvements they had made. Performance in 2015/16 indicated 92% of patients on the register had an agreed care plan and 95% had their alcohol consumption recorded.
  • The percentage of patients diagnosed with dementia whose care had been reviewed in a face-to-face review within the preceding 12 months was better than the national average at 100% (compared to a national average of 84.0%).
  • The practice had identified one percent of their population with enduring mental health conditions on a patient register to enable them to plan and deliver relevant services.
  • The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
  • There was 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 people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 8 June 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 patients with learning disabilities.
  • Staff carried out annual health checks for patients who had a learning disability and offered longer appointments.
  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
  • Staff provided vulnerable patients with information about how to access various support groups and voluntary organisations.
  • Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff understood their responsibilities regarding information sharing, the documentation of safeguarding concerns and contacting relevant agencies.