• Doctor
  • GP practice

Archived: East Leake Medical Group

Overall: Outstanding read more about inspection ratings

East Leake Health Centre, Gotham Road, East Leake, Loughborough, Leicestershire, LE12 6JG (01509) 852181

Provided and run by:
East Leake Medical Group

Important: The provider of this service changed. See new profile

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Background to this inspection

Updated 18 May 2018

East Leake Medical Group is registered with the CQC as a GP partnership with six GP partners. The practice is based at East Leake Health Centre, Gotham Road, East Leake, Loughborough, Leicestershire LE12 6JG. There are also two branch sites in the nearby villages of Sutton Bonnington and Ruddington. We visited East Leake Health Centre and the Sutton Bonnington and Ruddington branch sites during our inspection.

The practice has a population of 13,608 patients and is in one of the least deprived areas of England. 3.5% of patients are from black and minority ethnic groups.

The Sutton Bonnington branch is able to offer dispensing service to patients who live more than one mile (1.6km) from their nearest pharmacy.

The practice is open from 8am until 6.30pm Monday to Friday with appointments available at varying times across the three sites. Extended hours appointments are available at the practice from 7am three mornings per week.

Patients can also access extended hours appointments between 6.30pm and 8pm in the evening on weekdays and between 8.30am and 12.30pm at weekends via the Rushcliffe area extended hours service.

When the practice is closed patients are advised to contact the NHS 111 service if they require urgent medical advice.

The practice has a range of clinical staff available to support patients. Alongside the six GP partners the practice employs two salaried GPs. (In total six male and two female GPs.) The practice is a teaching practice and accommodates placements for GP registrars. At the time of this inspection there were three GP registrars working at the practice. (A registrar is a qualified doctor who is training to become a GP). The practice is also a training practice providing training sessions to medical students on a rotational basis. The practice employs a nurse practitioner, two practice nurses and three health care assistants.

Further information about the practice can be found on their website; www.elmgroupsurgeries.com

This inspection is a comprehensive ratings inspection as part of our sample of locations previously rated Good or Outstanding. There are no specific concerns or known risks.

The practice was previously inspected in February 2015 and rated Outstanding. That report can be found on the CQC website at;

http://www.cqc.org.uk/location/1-582137422

Overall inspection

Outstanding

Updated 18 May 2018

This practice is rated as Outstanding overall. (Previous inspection February 2015 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

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 – Outstanding

People with long-term conditions – Outstanding

Families, children and young people – Outstanding

Working age people (including those recently retired and students – Outstanding

People whose circumstances may make them vulnerable – Outstanding

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

We carried out an announced comprehensive inspection at East Leake Medical Group on 16 and 21 March 2018 as part of our inspection programme.

At this inspection we found:

  • There were safety policies including adult and child safeguarding policies in place and staff were familiar with these. Staff received safety information as part of their induction and refresher training and knew how to raise concerns.

  • The practice identified vulnerable patients and worked with other agencies to support and protect them from neglect and abuse.

  • Care records gave the information needed to deliver safe care and treatment and were accessible to relevant staff in an accessible way, including for extended hours appointments.

  • Arrangements for the storage of medicines and the operation of the dispensary kept patients safe.

  • Patients participated in national screening programmes and health initiatives with encouragement and support from the practice.

  • The most recent published QOF results were 100% of the total number of points available compared with the clinical commissioning group (CCG) average of 99% and national average of 96%. The overall exception reporting rate was 6% compared with a CCG and national average of 10%.

  • Patients could access services in ways that were convenient to them, including using online services and accessing routine appointments with GPs and nurses outside of usual surgery hours.

  • The practice collaborated with stakeholders and played a key role in developing services across the whole CCG area.
  • Staff were respected and valued. They felt proud to work for the practice.

  • The patient participation group (PPG) played an active role in representing patient views and developing services.

  • The practice was open to innovation and developed new ways to improve services for patients.

We saw areas of outstanding practice:

  • The practice had initiated, piloted and participated in the development of an innovative and comprehensive electronic system to guide clinicians along appropriate care pathways and aid their decision making. This was known as ‘F12 Pathfinder’ and meant clinicians pressed one key to access all the templates and protocols they needed when considering the health needs of patients. The F12 Pathfinder system was built into the electronic record system and templates were automatically pre-populated with individual information from patient records. There were templates for a broad range of health issues including for example, heart failure and cancer, which meant clinicians were confident they were following relevant up to date guidance and pathways and had support for their decision making. In each case, the template guided clinicians through the relevant pathway, ensuring accurate information was gathered, basic investigations completed, tests carried out and referrals made. The templates were personalised to the Rushcliffe area and reflected the services that were available to the practice, for example giving details of local clinics and their referral criteria.

  • The practice collaborated with stakeholders and played a key role in developing services in the practice and across the whole CCG area, including the ‘Let’s Live Well in Rushcliffe’ scheme and the extended hours service. They had developed a programme to identify patients with undiagnosed atrial fibrillation (AF) and this had been successful in increasing the numbers of patients identified and treated for this long term condition. Their development of a multi-agency CCG wide model of enhanced care home support for older people had improved care for these patients and resulted in a reduced number of emergency admissions to hospital. The practice were active in the GP Federation and GPs from East Leake Medical Group took lead roles in the development of services across the local health community.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 13 August 2015

The practice is rated as good for the care of people with long-term conditions. A comprehensive annual review was offered to patients with long term conditions such as, diabetes, asthma, chronic heart disease (CHD) and hypertension (high blood pressure). The practice had instigated a ‘Red Dot’ system to identify patients with multiple long term conditions and ensure they were allocated longer appointments to have annual reviews for all their conditions at one appointment. The practice had recorded that 50% of patients identified as requiring the longer appointments had accessed one this year.

Where possible, reviews were carried out by the same nurse or other clinician to ensure continuity of care for patients. Additional training had been provided to the healthcare assistant to enable them to carry out annual health checks.

Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments of up to one hour and home visits were available where required. All these patients had a named GP. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

The practice had designed and implemented its own templates to monitor and risk assess patients with long term conditions which improved outcomes. The lead partner at the practice was also the lead GP for long term conditions with the CCG which helped ensure best practice was in place.

Families, children and young people

Outstanding

Updated 13 August 2015

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

The practice had signed up to the Family Nurse Partnership. This is a national programme which provides staff with resources and training to support young mothers and fathers. The programme aims to improve the parenting skills of vulnerable young people.

The practice had innovative ways of working with this patient group. For example, following a cluster of suicides of young people in the local area, the practice had worked with a voluntary partner to develop a strategy to support young people in crisis and at risk of suicide. The project included talking therapies, counselling and referral to additional support. The programme was adopted across the county. Data showed that 84 patients across the CCG area had accessed this service and over 1000 young people had received training, talks and informal support from staff of the project.

All day access to health visitors, community midwives and a counselling service was offered at the practice, which significantly improved access for young patients and families.

Patients and staff 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. 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.

Childhood immunisations were similar to or above CCG average at all age groups and above CCG and National averages from age five upwards. For example practice figures for Hib/Meningitis C Booster at age five was 95.2% compared to a CCG figure of 92.2%.

Older people

Good

Updated 13 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people, for example rheumatoid arthritis and heart failure.

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 support of care homes and monitoring patients with long term conditions. It was responsive to the needs of older people and those in care homes by offering joint visits by the GP and community nurse which had resulted in fewer emergency calls and improved patient outcomes. Longer appointments were available for those who required them.

Working age people (including those recently retired and students)

Good

Updated 13 August 2015

The practice is rated as good for the care of 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 offered continuity of care. For example the practice offered appointments from 7am on Tuesday and Thursday. Additionally patients were actively encouraged to say if they felt they would need a longer appointment via the practice website. 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. For example 86.5% of eligible patients had attended for cervical screening. This was above the CCG and National figures of 83.4% and 74.3% respectively.

People experiencing poor mental health (including people with dementia)

Outstanding

Updated 13 August 2015

The practice is rated as outstanding for the care of people experiencing poor mental health (including people with dementia).

Eighty-six percent of people experiencing poor mental health had received an annual physical health check. This was better than both the local CCG and National averages of 81% and 78% respectively. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and SANE. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

The practice had proactively identified a need to develop strategies and support for young people in the area following a cluster of suicides. They had worked with a voluntary partner to develop a strategy to support young people in crisis and at risk of suicide. The project included talking therapies, counselling and referral to additional support. The programme was adopted across the county. Evidence showed that 84 patients across the CCG area had accessed this service and over 1000 had received training, talks and informal support from the project.

An IAPT (Improving Access to Psychological Therapies) team was based at the practice with clinics offered three times per week and throughout the day to enable young people to access these services at convenient times for them.

People whose circumstances may make them vulnerable

Good

Updated 13 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 homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 100% of these patients had attended for a follow-up. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. For example Citizens Advice Bureau and carers support groups. 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.

Specific training for GP registrars was given on how consultation skills and shared decision making for vulnerable patients. We saw that this was followed by reflection on these skills with the registrar’s mentor. This led to safer, more consistent care and improved clinical outcomes for patients

Appointments of up to one hour were available to people in vulnerable circumstances and those with long term conditions

Patients who were unable to access the service could nominate a named person to discuss pathology results and collect repeat prescriptions.