Letter from the Chief Inspector of General Practice
This practice is rated as Good overall.
The practice had been previously inspected on 22 September 2015 when it was rated as Good overall, with one domain being rated Requires Improvement for the provision of responsive services.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
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 Lupset Health Centre on 15 November 2017. The inspection was carried out as part of our inspection programme and was also used to follow up areas where at the time of the last inspection, on 22 September 2015, the provider was informed they should take action to improve some areas in respect of the provision of responsive services. This included improving access to the practice for patients with a disability, improving the ease of patients contacting the practice by telephone, and the need to provide patients with access to information about how to make a complaint. We noted at the 15 November 2017 inspection that the practice had taken action to improve these service areas.
At this inspection we found:
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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.
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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.
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A number of higher level services were provided within the practice which would otherwise be usually delivered in secondary care settings.
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The practice showed better than average performance in relation to the prescribing of antibiotic items.
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The practice offered home visits from 9am, which supported provision of earlier interventions, and prevented deterioration and possible admission to secondary care services. Urgent care was also prioritised with appointments being available for these patients on the day of presentation.
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Staff discussed treatment options with patients, and we were told by carers and patients that they were treated with compassion, kindness, dignity and respect by all the staff in the practice.
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The practice provided services to patients who were assessed as being potentially violent and had been excluded from mainstream GP services.
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Public engagement was positive and active. The practice sought patient feedback via a number of routes, such as carrying out individual surveys and engagement with the established Patient Participation Group. The practice was responsive to patient feedback and had implemented improvements to the practice telephone system in light of previous low patient satisfaction.
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There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw two areas of outstanding practice:
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The practice recognised there was high local patient demand for mental health services (including those for dementia). In response to this it had employed a mental health nurse and delivered a number of dedicated services to meet these needs.
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The practice provided services to patients who had been assessed as being potentially violent, and had therefore been excluded from accessing services provided by their own GP practice. As well as having delivered care to these patients, over time Lupset Health Centre had supported a significant number to return to other mainstream GP services.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice