Archived: Windmill Medical Practice

Updated 11 July 2016

Windmill Medical Practice provides primary medical services in Denton, Tameside from Monday to Friday. The surgery is open:

Monday: 7.30am to 8.00pm

Tuesday: 8.00am to 6.00pm

Wednesday: 8.00am to 6.00pm

Thursday: 8.00am to 8.00pm

Friday: 7.30am to 6.00pm

Appointments with a GP are available between 8.30am - 12.00pm and 3.00pm - 6.00pm. The practice also offers early appointments two mornings a week from 7:30am and two late evening appointments between 6:30 and 8:00pm. Early morning nurse appointments are available from 7:30am Monday mornings

Denton is situated within the geographical area of Tameside and Glossop Clinical Commissioning Group (CCG).

Windmill Medical Practice is responsible for providing care to 13603 patients.

The practice consists of four GP partners, one of whom was due to leave the practice in July 2016 after a period of sick leave. At the time of our inspection there were three GP partners (male), a female part time salaried GP and long term locums. The practice employed Nurse practitioners, practice nurses, health care assistants and an assistant practitioner. There was a vacant post for a nurse practitioner. The practice is supported by practice development manager, practice manager, receptionists and administrators.

When the practice is closed patients are directed to the out of hours service.

Updated 11 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Windmill Medical Practice on 13 May 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Data showed patient outcomes were in line with or above those locally and nationally.
• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 July 2016

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.
• Where appropriate patients with more than one long-term condition were able to access a joint review to prevent them having to make multiple appointments.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For patients with complex needs, a named GP and practice nurse worked with relevant community and healthcare professionals to deliver multidisciplinary support and care. Multidisciplinary meetings were held to review patients’ needs and to avoid hospital admissions.
• Patients with COPD and Asthma had self-management plans and access to medication at home for acute exacerbations and were directed to a structured education programme.

Updated 11 July 2016

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

• There were systems in place 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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients 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 and health visitors. A midwife held antenatal clinics weekly.
• A contraceptive service including the fitting of contraceptive coils and implants was available for patients and offered to patients from other practices in the area. A family planning drop in clinic was held every Thursday afternoon.
• The practice held a weekly Healthy woman clinic to enable more complex problems to be investigated.

Updated 11 July 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had a Carers’ Champion who proactively contacted all patients over the age of 75 and sent them an “Over 75’s Birthday Card” the month before their 75th birthday. Patients had the opportunity to be referred on to the Age UK Befriending Service
• The practice embraced the Gold Standards framework for end of life care. This included supporting patients’ choice to receive end of life care at home.

Updated 11 July 2016

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.
• Appointments were available outside of normal working hours, with three evening surgeries and two early morning surgeries.
• 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 11 July 2016

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

• 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months.
• 72% of patients with poor mental health had a comprehensive care plan documented in the record agreed between individuals, their family and/or carers as appropriate. However we noted 62.65% exception reporting. Although exception reporting was high this included patients who had opted out of attending for reviews and there were some errors in coding. We were informed by the practice that some patients had in fact got care plans but this information had not been recorded.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 how to access various support groups and voluntary organisations. The practice promoted self-referral to the local “Healthy Minds” service.
• It had a system in place to follow up patients who may have been experiencing poor mental health and had attended accident and emergency.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 11 July 2016

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 those with a learning disability. Vulnerable patients were identifiable with alerts noted on the secure computer system to ensure staff were alerted to needs.
• Annual reviews were provided for patients with learning disabilities, using a nationally recognised tool.
• The practice was proactive in monitoring those patients identified as vulnerable or at risk. This included, monitoring A&E attendances, monitoring missed appointments from those known to be vulnerable and working with other services to ensure, where appropriate, information was shared to keep patients safe.
• 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.
• 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.