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Dr P J P Holden & Partners Outstanding Also known as Imperial Road Surgery

We are carrying out checks at Dr P J P Holden & Partners. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Outstanding

Updated 22 January 2015

Letter from the Chief Inspector of General Practice

We inspected this practice on 08 October 2014, as part of our new comprehensive inspection programme. The practice had not previously been inspected.

We found the practice to be good in safe, caring and responsive areas we inspected, and outstanding in effective and well-led. The overall rating is outstanding. 

Our key findings were as follows:

Patients expressed a high level of satisfaction about the care and services they received.

Systems were in place to keep patients safe and to protect them from harm.

Patients were asked for their views, and their feedback was acted on to improve the service.

Patients were treated with kindness, dignity and respect.

The practice worked in partnership with other services to meet patients’ needs in a responsive way.

Staff were supported to share best practice, acquire new skills and further develop their knowledge to meet patients’ needs and provide high quality care.

The culture and leadership empowered staff to carry out lead roles and innovative ways of working to meet patients’ needs, and drive continuous improvements. The leadership and governance arrangements also ensured the delivery of high-quality person-centred care.

We saw several areas of outstanding practice including:

The practice had links with local schools and had provided several presentations to pupils about health issues. Pupils from a local school had designed the new logo for the practice.

The leadership enabled staff to drive continuous improvements and carry out lead roles and innovative ways of working to meet patients’ needs. For example, the community matron regularly visited patients in their own home and local care homes in response to their needs, and held quarterly meetings with the practice manager and care home managers to review their needs.

The practice provided medical support to a local drug misuse service, and was helping to change perceptions about people who had a drug dependencyThe practice worked pro-actively with relevant services, which had enhanced their safeguarding links and holistic approach to supporting families and patients who had a drug dependency.

The Patient Reference Group were actively involved in recruiting senior staff including the current practice manager. 

In addition the provider should:

Complete a competency assessment to evidence that the health care assistant has been assessed competent to carry out specific health checks and delegated tasks.

 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 22 January 2015

The practice is rated as good for safe. Patients told us they felt safe when using the service.Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses. Systems were in place to keep patients safe and to protect them from harm. Safety issues were recorded, monitored and reviewed. Lessons were learned and communicated widely to support improvement. There were enough staff to keep people safe. Arrangements were in place to ensure that the practice was clean, safe and well maintained.

Effective

Outstanding

Updated 22 January 2015

The practice is rated as outstanding for effective. There was a holistic and pro-active approach to meeting patients’ needs which was driven by all staff at the practice. Patients’ needs were assessed and their care and treatment was delivered in line with evidence based practice. Patients were regularly reviewed to assess the effectiveness of their care and treatment. The services were very effective as all staff had clear roles in monitoring and improving outcomes for patients, resulting in a practice wide approach to care and treatment. Completed clinical audits were used to monitor, measure and improve the care and outcomes for patients. Staff worked in a proactive way and in collaboration with partner health and social care services to meet patients’ needs. The practice had an established and experienced staff team, with a wide range of skills to enable them to deliver effective care and treatment. Staff were supported to share best practice, acquire new skills and further develop their competence and knowledge to meet patients’ needs and ensure high quality care.

Caring

Good

Updated 22 January 2015

The practice is rated as good for caring. Patients described the staff as friendly and caring, and said that they felt that they treated them with respect and dignity.  Patients were involved in decisions about their health and treatment, and received support to cope emotionally with their care and condition.  We saw that patients’ privacy, dignity and confidentially were maintained; staff were respectful, polite and friendly when dealing with patients. The practice was recently awarded a Carers Pledge and was due to complete a bronze dignity award, in recognition of their commitment to ensuring that carers feel valued and are treated with dignity and respect.

Responsive

Good

Updated 22 January 2015

The practice is rated as good for responsive. The appointment system was flexible and was regularly reviewed to enable people to access care and treatment when they needed it. The practice worked in partnership with other providers and organisations to meet patients’ needs in a responsive way. The practice had good facilities and was well equipped to treat patients and meet their needs. Patients concerns and complaints were listened and responded to and used to improve the service.

Well-led

Outstanding

Updated 22 January 2015

The practice is rated as outstanding for well-led.  Patients were asked for their views, and their feedback was used and acted on to continuously improve the service. The culture, leadership and governance arrangements were robust and ensured the delivery of high-quality person-centred care. A clear business plan was in place, which set out the plans for future development and demonstrated a commitment to ongoing improvement. Regular meetings were held to discuss the business, finances, governance and performance. The systems for driving improvements and monitoring the quality of care and services had been strengthened. Robust processes and systems were in place to ensure that the service was well managed, and for identifying and managing risks. There was strong teamwork, leadership, and commitment to improving the quality of care and people’s experiences amongst all members of practice staff. There was a very open, positive and supportive culture. There were high levels of staff satisfaction and engagement.  The culture and leadership empowered staff to carry out lead roles and innovative ways of working to meet patients’ needs, and to drive continuous improvements. All staff had clear roles and responsibilities to ensure that the practice was well led. There was an active approach to seeking out new ways of providing care and treatment.

Checks on specific services

People with long term conditions

Good

Updated 22 January 2015

The practice is rated as good for the care of people with long term conditions. All patients were offered an annual review including a review of their medication, to check that their health needs were being met. When needed longer appointments and home visits were available. Where possible, clinicians reviewed patient’s long term conditions and any other needs at a single appointment, to prevent them from attending various reviews. Emergency processes were in place and referrals were made for patients that had a sudden deterioration in their health. For those people with the most complex needs, a named GP worked with relevant health and care professionals to deliver multidisciplinary support and care.

Families, children and young people

Good

Updated 22 January 2015

The practice is rated as good for the care of families, children and young people. Systems were in place for identifying and following-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 high for all standard childhood immunisations. The practice worked in partnership with midwives, health visitors and school nurses. Appointments were available outside of school hours to enable children to attend. The practice worked with local schools to provide education on health issues and to promote their involvement.  

Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Older people

Outstanding

Updated 22 January 2015

The practice is rated as outstanding for the care of older people. Patients 65 years and over were offered an annual health check. All patients 75 years and over had a named GP to offer continuity of care to ensure that their needs were being met. Health care plans were provided for patients over 75 years, to help avoid unplanned admissions to hospital. Carers were identified and supported to care for older people. Home visits were carried out for elderly housebound patients.

The practice part funded a community matron’s post who supported elderly patients and those with complex needs, to prevent avoidable admissions to hospital and improve outcomes for patients. The community matron regularly visited patients in their own homes and local care homes in response to their needs, and reviewed and referred them to ensure their needs were being met. They also helped the care home staff to complete appropriate assessments and care plans for patients, and provided advice and support to develop staff’s knowledge and skills. The community matron and practice manager also held quarterly meetings with the care home managers to review developments relating to patients’ needs.

Working age people (including those recently retired and students)

Good

Updated 22 January 2015

The practice is rated as good for the care of the working-age people (including those recently retired and students). The practice provided extended opening hours to enable patients to attend in an evening or early morning. Patients were also offered telephone consultations and were able to book non urgent appointments around their working day by telephone, on line and using the 24 hour automated service. The practice offered a ‘choose and book’ service for patients referred to secondary services, which enabled them greater flexibility over when and where their test took place. NHS health checks were offered to patients over 40 years. The practice was proactive in offering health promotion and screening appropriate to the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 22 January 2015

The practice is rated as good for the care of people experiencing poor mental health. The practice held a register of patients experiencing poor mental health.  Patients were offered an annual health, including a review of their medicines.  The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, to ensure their needs were regularly reviewed, and that appropriate risk assessments and care plans were in place. Patients were supported to access emergency care and treatment when experiencing a mental health crisis.

People whose circumstances may make them vulnerable

Good

Updated 22 January 2015

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 people with learning disabilities. Patients with a learning disability were offered an annual health review, including a review of their medication. When needed longer appointments and home visits were available. The practice was part of a local scheme to support the most vulnerable patients with the aim of managing their needs at home and avoiding unplanned hospital admissions.

The practice worked with multi-disciplinary teams in the case management of people in vulnerable circumstances and at risk of abuse. The practice provided medical support to a local drug misuse service, and provided a holistic approach to supporting families and patients who had a drug dependency.