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Meadow Dale Group Practice Good

Inspection Summary


Overall summary & rating

Good

Updated 6 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Meadow Dale Group Practice on 14 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also rated as good for providing services for all population groups.

Our key findings across all the areas we inspected were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services was available and easy to understand.
  • Patients said they found the appointment system very accessible.
  • 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 it acted on.

There were areas of outstanding practice.

  • We found there were outstanding processes in place to manage incidents. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses and they had received training in this area. Detailed policies and procedures were in place to support practice. Incidents were recorded electronically and monitored for patterns and trends at local, regional and national level. Lessons were learned and communicated widely to support improvement.
  • We found there were outstanding processes in place for the management of medicines. Detailed procedures were in place for all aspects relating management of medicines and clinical staff had received medicines management training. Detailed audit processes were in place to monitor medicines and compliance with policies and procedures. There were systems in place which ensured GPs had time to review repeat prescriptions.
  • We found there were outstanding governance systems in place. The practice had a clear vision and strategy and this was embedded in aspects of practice. 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 both at the practice and regionally. The practice had a number of detailed policies and procedures to govern activity and held regular governance meetings. There were systems in place to monitor and improve quality and identify risk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 6 August 2015

The practice is rated as good for providing safe services. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. Staff had completed training and there were enough staff to keep patients safe. The practice monitored systems and processes for infection control and the practice was visibly clean.

Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses and they had received training in this area. Detailed policies and procedures were in place to support practice and incidents were monitored for patterns and trends at local, regional and national level. Lessons were learned and communicated widely to support improvement.

Detailed procedures were in place for all aspects relating management of medicines and clinical staff had received medicines management training. Detailed audit processes were in place to monitor medicines and compliance with policies and procedures. There were systems in place which ensured GPs had time to review repeat prescriptions.

Effective

Good

Updated 6 August 2015

The practice is rated as good for providing effective services. Data showed most patient outcomes were at or above average for the locality. Staff referred to guidance from National Institute for Health and Care Excellence (NICE) and used it routinely. Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training appropriate to their roles. The management team had identified improvements in monitoring patient’s care needs, for example, improvements in diabetes care was required and they had implemented an action plan to improve these areas. There was evidence of appraisals and personal development plans for staff. Staff worked well with multidisciplinary teams.

Caring

Good

Updated 6 August 2015

The practice is rated as good for providing caring services. Evidence from data and discussions with patients showed patients rated this practice highly in all aspects of their care. They said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information to help patients understand the services available was easy to understand. We saw staff treated patients with kindness and respect.

Responsive

Good

Updated 6 August 2015

The practice is rated as good for providing responsive services. The practice reviewed the needs of its local population when developing service. They engaged with the NHS England Area Team and Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. Evidence from data and discussions with patients showed patients were highly satisfied with the appointments system in place. The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available on the website and in the practice. The information was easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 6 August 2015

The practice is rated as good for being well-led. We found there were outstanding governance systems in place. The practice had a clear vision and strategy and this was embedded in aspects of practice. 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 both at the practice and regionally. The practice had a number of detailed policies and procedures to govern activity and held regular governance meetings. There were systems in place to monitor and improve quality and identify risk. The practice sought feedback from staff and patients, which it acted on. The practice had identified that it could improve patient engagement and was in the process of developing a Patient Participation Group (PPG). Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

People with long term conditions

Good

Updated 6 August 2015

The practice is rated as good for the care of people with long-term conditions. The GP and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified and monitored. Home visits were available when needed. All these patients had a named GP and a structured annual review to check their health and medication needs were being met. For those people with the most complex needs, the practice worked with relevant health and care professionals to monitor patient outcomes and to deliver a multidisciplinary package of care. Patients with palliative care needs could attend any clinical session without needing to make an appointment. The practice held a number of in-house clinics to support this group of patients such as, clinics for asthma, diabetes, Chronic Obstructive Pulmonary Disease (COPD) and coronary heart disease.

Families, children and young people

Good

Updated 6 August 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances who were at risk, Appointments were available outside of school hours and the premises were suitable for children and babies. The practice worked closely with other agencies such as the health visitors and held a number of in-house health care clinics.

Older people

Good

Updated 6 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed outcomes for patients were good for conditions commonly found in older people. All patients over 75 years of age had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits. Monthly multi-disciplinary meetings were held to review the care needs of older people. The practice worked closely with other health and social care organisations and ran a number of in-house clinics.

Working age people (including those recently retired and students)

Good

Updated 6 August 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The services offered ensured appointments were accessible, flexible and offered continuity of care. Pre-bookable, telephone consultations, Saturday and late evening appointments were all available to this group of patients.

The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. A number of clinics were also available in-house such as smoking cessation.

People experiencing poor mental health (including people with dementia)

Good

Updated 6 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health.

The practice had told patients experiencing poor mental health about how to access various support groups and counselling services.

People whose circumstances may make them vulnerable

Good

Updated 6 August 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 those with a learning disability. It offered annual reviews for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It signposted vulnerable patients to access various support groups and voluntary organisations. Staff had access to tools such as a translation services to assist communication with patients where English was not their first language. 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 normal working hours and out of hours.