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Aspull Surgery Good Also known as Drs Van Spelde and Greiss

Inspection Summary


Overall summary & rating

Good

Updated 17 November 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 5 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 inspection at Aspull Surgery on 2 November 2017. We carried out a comprehensive inspection of this service under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • 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.

  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

  • 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 November 2017

Effective

Good

Updated 17 November 2017

Caring

Good

Updated 17 November 2017

Responsive

Good

Updated 17 November 2017

Well-led

Good

Updated 17 November 2017

Checks on specific services

People with long term conditions

Good

Updated 8 January 2015

The practice is rated as good for the population group of people with long term conditions.  Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. All these patients had structured annual reviews to check their health and medication needs were being met. For those people with the most complex needs GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 8 January 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 vulnerable families 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.

Appointments were available outside of school hours and the premises were suitable for children and babies. All of the staff were very responsive to parents’ concerns and ensured parents could have same day appointments for children who were unwell.

Nursing staff were mindful of symptoms of post natal depression and  discussed this with new mothers.

A midwife ran antenatal clinics weekly from the practice. Where patients were suspected to be victims domestic violence, this was recorded within patient records and staff were vigilant and made appropriate referrals where necessary with consent.

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

Staff were knowledgeable about child protection and a GP took the lead with the Local authority and other professionals to safeguard children and families.

Young people requiring sexual health advise were supported by the practice and/or referred to Brook a young people’s sexual health service.

Older people

Good

Updated 8 January 2015

The practice is rated as good for the population group of older people.  Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people.  The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia, shingles vaccinations and end of life care.  The care for patients at the end of life was in line with the Gold Standard Framework, working as part of a multidisciplinary team and with out of hours providers to ensure consistency of care and a shared understanding of the patient’s wishes.

The practice was responsive to the needs of older people, with one of the GPs taking a special interest in care of the elderly. GPs, nurses and health care assistants provided home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 8 January 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group. Patients were provided with a range of healthy lifestyle support including smoking cessation with referrals available to Health trainers.  The practice had extended opening hour enabling people to make appointments outside normal working hours. Appointments could be booked online and up to four weeks in advance.

Find and treat, a service which provides opportunistic or planned health check for patients aged 40-74 years were in place, and consisted of height, weight and blood pressure checks and blood tests.

People experiencing poor mental health (including people with dementia)

Good

Updated 8 January 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients who experienced mental health problems. The register supported clinical staff to offer patients an annual appointment for a health check and a medication review. 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 in place advance care planning for patients with dementia. 

The practice had sign-posted patients experiencing poor mental health to various support groups and voluntary organisations, including referrals to counselling services.

For patients who experienced difficulties attending appointments at busy periods they would be offered appointments at the beginning or end of the day to reduce anxiety.

People whose circumstances may make them vulnerable

Good

Updated 8 January 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice had carried out annual health checks for people with learning disabilities and  offered longer appointments for people where required. For patients where English was their second language, an interpreter could be arranged.

The practice provided care and treatment to asylum seekers placed within Wigan by providing patient centred, systematic and ongoing support.

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 voluntary 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.