Background to this inspection
Updated
8 August 2018
Vesta Road Surgery provides primary medical services in the London Borough of Lewisham to approximately 6,300 patients. The practice operates at 58 Vesta Road, Brockley, London SE4 3NH. The practice is based in a purpose-built building, and there are consulting rooms on the ground floor and first floor of the building. There are administrative offices on the first floor of the building and on the third floor.
The practice population is in the fifth most deprived decile in England (the practice scored 5 on the scale of deprivation where 1 is the most deprived area and 10 the least deprived). The practice population’s age demographic is not in line with the national average. The practice has a significantly higher proportion of patients between the ages of 25–39, and a far lower number of patients for all age groups over 54. The practice provides 21 GP sessions per week. The practice operates under a General Medical Services (GMS) contract. The practice has responsibility for providing GP services to one nursing home which has 80 residents.
Vesta Road Surgery is operated by two GP partners. There is a locum GP employed at the practice. There are three part-time practice nurses and one phlebotomist. At this inspection, we were not able to speak to the nurse prescriber. The clinical team is supported by a Practice Manager, assistant practice manager and 8 administrative and reception staff.
The practice reception is open between 8.00am and 6.30pm Monday to Friday. Extended hours are available between 6.30pm until 7.30pm on Wednesdays and 9.00am until 12.30pm on Saturdays. When the practice is closed patients are directed to contact the local out of hours service (SELDOC) and NHS 111.
The practice is registered as an individual provider with the Care Quality Commission to provide the regulated activities of family planning, treatment of disease, disorder or injury; diagnostic and screening services, maternity and midwifery services and surgical procedures. The practice offers travel immunisations and is a Yellow Fever centre.
The service was previously inspected on 15 November 2016 where the overall rating was found to be Good overall, but Requires Improvement for Caring. The report found the practice must undertake the following:
- The practice should ensure that it takes action to address lower scoring areas in the national patient survey.
The full comprehensive report of the 15 November 2016 inspection can be found by selecting the ‘all reports’ link Vesta Road Surgery on our website at .
We carried out an announced focused inspection on 4 September 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 15 November 2016. Overall the practice was rated as good, although it remained requires improvement for Caring.
Updated
8 August 2018
This
practice is rated as Good overall. (Previous inspection November 2016 rated – Good overall, Requires Improvement for Caring).
We carried out an announced comprehensive inspection at Vesta Road Surgery on 30 May 2018. inspection programme.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
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
At this inspection we found:
- The practice still scored below the national average in the National GP Patient Survey in relation to consultation satisfaction with both doctors and nurses. However, the practice had taken action to address lower scoring areas in the NHS national patient survey.
- 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.
- The practice had implemented defined and embedded systems to minimise risks to patient safety.
- Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
- 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.
- Some of the patients we spoke with said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- All of the 24 patient Care Quality Commission comment cards we received were positive about the service experienced.
- Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw one area of outstanding practice:
- The practice had chosen to provide GP services to a local nursing home. The practice initiated a programme of change from a paper based patient care record system to an electronic one. The service helped to establish a wireless connection in the care home so that a laptop could be connected and care records could be accessed by the bedside of patients to improve recording and treatment.
The areas where the provider should make improvements are:
- The practice should continue to monitor patient satisfaction about patient involvement in decisions about their care, and take action when necessary to improve satisfaction
- The practice should review actions to address lower scores in the uptake of national childhood immunisations.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice