Archived: Yare Valley Medical Practice

Updated 20 June 2016

Letter from the Chief Inspector of General Practice

We carried out a desk based review for Yare Valley Medical Practice on 1 June 2016. This was to follow up on actions we asked the provider to take after our announced comprehensive inspection on 6 October 2015. During the inspection in October 2015, we identified that not all staff that undertook chaperone duties had received a disclosure and barring check (DBS) or had a written risk assessment completed (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). During the inspection on 1 June 2016 the business manager showed us they were in the process of undertaking DBS checks for every member of staff.

The provider provided us with evidence that DBS checks had been completed for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 December 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication 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 10 December 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 children living in disadvantaged circumstances and who were at risk. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Appointments with GPs and nurses were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with midwives and community services. Antenatal care was referred in a timely way to external healthcare professionals. Patients we spoke with were positive about the services available to them and their families at the practice. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 10 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were in line with national averages for conditions commonly found in 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 and end of life care. The practice participated in regular meetings with the other health care providers, such as palliative care teams. The practice provided weekly ‘ward rounds’ to two local residential care homes, giving residents regular and consistent contact for non-urgent health issues.

Updated 10 December 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 had introduced late evening extended hours appointments during the week and also on occasion Saturday morning appointments. 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.

Updated 10 December 2015

The practice proactively identified patients who may be at risk of developing dementia. The practice were aware of the number of patients they had registered with dementia and additional support was offered. This included those with caring responsibilities. A register of dementia patients was being maintained and their condition regularly reviewed through the use of care plans. Patients were referred to specialists and then on-going monitoring of their condition took place when they were discharged back to their GP. Annual health checks took place with extended appointment times if required. Patients were signposted to support organisations such as the mental health charity MIND, Improving Access to Psychological Therapies (IAPT) and the community psychiatric nurse for provision of counselling and support. However not all staff had a clear understanding of the Mental Capacity Act and their role in implementing the Act. The business manager had designed a template for patients with a diagnosis of dementia, this included amongst other things detailed patient identification, their next of kin contact information, legal representation information and health and medication information. This provided practice staff with instant access to any information required should the patient health suddenly deteriorate.

Updated 10 December 2015

The practice is rated as good for the population group of people whose circumstances might make them vulnerable. Double appointment times were offered to patients who were vulnerable or with learning disabilities. Carers of those living in vulnerable circumstances were identified and offered support which included signposting them to external agencies. Staff knew how to recognise signs of abuse in vulnerable adults and children. All staff had been trained in safeguarding and were very aware of the different types of abuse that could occur and their responsibilities in reporting it. 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. The practice held monthly multi-disciplinary team (MDT) meetings attended by GPs, district nurses, practice nurses and when possible community psychiatric nurses to discuss vulnerable patients. The business manager provided support for vulnerable patients to complete benefit and other claims forms both electronically and written.