Blackthorn Medical Centre Also known as Drs McGavin, Witt, Gerhards & Lace

Updated 7 July 2017

Blackthorn Medical Centre is situated in Barming, near Maidstone, Kent. The practice has a general medical services contract with NHS England for delivering primary care services to the local community. The practice has a patient population of 7,320. The proportion of patients who were aged 20 to 39 is lower than national averages and the proportion of patients aged 40 to 49 is higher than the national average. The practice is in an area with a low deprivation score and lower than average levels of unemployment.

There are four GPs (two male, two female) who are partners, who are supported by two salaried GPs (one male, one female). All GPs at the practice work part-time. There are two nurses and three health care assistants (all female). In addition there are two management staff, one secretary, thirteen reception/administrative staff and four therapists.

Services are also offered in anthroposophic therapies (a system of therapies using mainly natural means to optimise physical and mental health and well-being). Therapies include biographical counselling (counselling aimed at supporting an individual to self-understanding), eurhythmy therapy (graceful body movements to the rhythm of spoken words or music), rhythmical massage, colour light and art therapy. These services are provided in addition to the practice’s NHS Contract and are free of charge to patients.

The practice is a training practice (training practices have GP trainees and Foundation Year Two trainee doctors). It also provides placements for registrars whose need for additional training has been recognised.

Patient areas are accessible to patients with mobility issues, as well as parents with children and babies. All consultation and treatment rooms are located on the ground floor. Therapy rooms are located on the first floor; there is a lift for access. There is a small car park with a dedicated disabled parking space. There is also parking for bicycles.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are offered on one Saturday morning each month as well as eveningtelephone appointments from 6.30pm to 7pm on Monday and Tuesday, early morning GP appointments from 7.30am to 8am on Wednesday, Thursday and Friday, and early morning nursing appointments from 7.30am to 8am on Tuesday and Thursday.

There are arrangements with other providers (Integrated Care 24) to deliver services to patients outside of the practice’s working hours.

Services are provided from:

• Blackthorn Medical Centre, St Andrews Road, Barming, Maidstone, Kent, ME16 9AN.

Updated 7 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Blackthorn Medical Centre on 27 July 2016. The overall rating for the practice was requires improvement. The practice was rated as inadequate for providing safe services, requires improvement for effective and well-led services and rated as good for providing caring and responsive services. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Blackthorn Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 25 May 2017, to confirm that the practice had carried out their plan to meet the legal requirements, in relation to the breaches in regulations that we identified in our previous inspection on 27 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• All staff including nurses were trained to the appropriate level in safeguarding children.
• The practice had systems and processes to assess and manage risks of infection, to ensure that equipment was in good working order and to ensure the safe storage of medicines.
• The practice carried out the necessary recruitment checks prior to employing staff.
• The practice had adequate equipment and medicines to respond to medical emergencies.
• There was an induction programme for newly appointed staff and an overall training schedule that ensured staff received training appropriate to their roles. There was a system that ensured all staff received annual appraisals.
• The practice had an active patient participation group and had sought feedback from patients through a patient survey which it acted on. The survey showed that patients’ awareness of online services had improved.
• An overarching governance framework supported good quality care. There were arrangements to monitor and improve quality and identify risk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Performance for diabetes related indicators was similar to the national average. For example, the percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding twelve months was 92% compared to the clinical commissioning group (CCG) and national average of 88%.
• The practice was leading an innovative project to support patients with diabetes.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency department (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors.
• The practice had close links with a local charity that offered support to families in crisis.

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice worked closely with the district nursing team.

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 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 help ensure these were accessible, flexible and offered continuity of care.

• The practice offered online services as well as a full range of health promotion and screening that reflects the needs for this age group. Feedback from patients had been sought through a patient survey which it acted on. The survey showed that patients’ awareness of online services had improved.
• The practice offered telephone triage as well as early, late and weekend appointments for patients who found it difficult to attend the practice during core working hours.

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 86% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is similar to the clinical commissioning group (CCG) average of 85% and the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record was 94% compared to the CCG and national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice had close links to the organisation which provided rehabilitation through training or work placements.

Updated 7 July 2017

The provider had resolved the concerns for providing safe, effective and well-led care identified at our inspection on 27 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. The practice was able to provide evidence to show that all staff had received safeguarding training appropriate to their roles and staff we spoke with were aware of the correct action to be taken in the event that they suspected a patient was suffering from abuse.