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Inspection Summary


Overall summary & rating

Good

Updated 14 March 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 4 November 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Arran Medical Centre on 10 January 2018 as part of our inspection programme

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. We saw that when incidents did happen, the practice discussed these at clinical meetings and learned from them and improved their processes as a result.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect and the National GP Patient survey results reflected this for example,

- 99% of patients who responded said the nurse was good at listening to them compared to the CCG average of 92% and the national average of 91%.

- 98% of patients who responded said they found the receptionists at the practice helpful compared to the CCG and national averages of 87%.

  • In addition comment cards we received reported high levels of satisfaction with the services at the practice and patients we spoke with were also provided positive feedback.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it. However we did receive feedback that it was sometimes difficult to get through to the practice on the telephone and survey results reflected this.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. This is a training practice and the GP registrars (a GP Registrar is a qualified doctor who is training to become a GP through a period of working and training in a practice) we spoke with felt well supported.

The areas where the provider should make improvements are:

  • Continue to monitor patient satisfaction rates in particular in relation to access to appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 March 2018

Effective

Good

Updated 14 March 2018

Caring

Good

Updated 14 March 2018

Responsive

Good

Updated 14 March 2018

Well-led

Good

Updated 14 March 2018

Checks on specific services

People with long term conditions

Good

Updated 28 May 2015

The practice is rated as good for the population group of people with long term conditions. The practice had a range of protocols in place which set out the processes for the management of patients with various long term conditions in line with best practice. Patients with long term conditions received regular reviews to check their health and medication needs from trained clinical staff that maintained their skills and knowledge in these areas. When needed, longer appointments and home visits were available.

The practice had identified patients and developed care plans for those with the most complex needs as part of the unplanned admissions enhanced service. The practice worked with relevant health care professionals to deliver a multidisciplinary package of care within the patient’s home. An enhanced service is a service that is provided above the standard general medical service contract.

Families, children and young people

Good

Updated 28 May 2015

The practice is rated as good for the population group 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 of harm. For example, children and young people who had a high number of A&E attendances. Well baby clinics and child health checks were carried out at the practice. Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with examples of joint working with midwives, health visitors and school nurses.

All staff had received training in safeguarding children so that they had the knowledge and understanding to act if they were concerned about a child.

Older people

Good

Updated 28 May 2015

The practice is rated as good for the care of older people. The practice offered proactive, personalised care to meet the needs of older patients in its practice population. There were a range of enhanced services, for example the unplanned admissions enhanced service. This was a scheme to avoid unplanned admissions to hospital by focusing and coordinating care for the most vulnerable patients. The aim was to effectively support them in their home. An enhanced service is a service that is provided above the standard general medical service contract.

The practice was responsive to the needs of older patients, including offering home visits, telephone consultations and rapid access appointments for those with complex needs.

Working age people (including those recently retired and students)

Good

Updated 28 May 2015

The practice is rated as good for the population group of the 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 offer continuity of care. The practice was proactive in offering online services, telephone consultations and had extended opening hours until 7.30pm on Tuesdays.

The practice offered health checks for patients between the ages of 40 to 74 and screening services such a cervical screening to help detect early signs of disease. There was a range of health information and promotion of health screening checks which reflected the needs for this age group. Patients that needed support to live healthier lifestyles were referred to appropriate services available outside the practice.

People experiencing poor mental health (including people with dementia)

Good

Updated 28 May 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. There were systems in place to ensure safe prescribing of antidepressants.

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations.

People whose circumstances may make them vulnerable

Good

Updated 28 May 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with learning disabilities. The register for patients with learning disabilities showed the majority had received an annual health check in the last 12 months. The practice offered longer appointments for people with learning disabilities.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.