• Doctor
  • GP practice

College Street Medical Practice

Overall: Good read more about inspection ratings

College St Medical Practice, 86 College St, Long Eaton, Nottingham, Nottinghamshire, NG10 4NP (0115) 973 4502

Provided and run by:
College Street Medical Practice

Latest inspection summary

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Background to this inspection

Updated 13 April 2020

College Street Medical Practice is registered with the Care Quality Commission as a partnership. It is registered to carry out the following regulated activities - diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures, and the treatment of disease, disorder or injury.

College Street Medical Practice is situated within the town of Long Eaton in the Erewash district of Derbyshire.

The practice has a contract with NHS Derby and Derbyshire CCG to provide Personal Medical Services (PMS) and offers a range of local enhanced services.

The practice has just over 6,300 registered patients. The age profile of patients is consistent with local and national averages.

The practice scored six on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have greater need for health services.

The National General Practice Profile describes the practice ethnicity as being predominantly white at 95.4% of the registered patients, with estimates of 1.6% mixed race, 1.9% Asian, 0.9% black and 0.2% other.

The partnership consists of a male GP and a female advanced nurse practitioner. There are three salaried GPs (two females and one male), two nurse practitioners and three practice nurses working at the practice.

The non-clinical team is led by a practice manager supported by an assistant practice manager and a team of reception, administrative and secretarial staff.

The practice opens Monday to Friday from 8am until 6.30pm. Additional appointments are available through a local extended access scheme on weekday evenings and weekends.

The surgery closes on a Wednesday afternoon on most months for staff training. When the practice is closed, out of hours cover for emergencies is provided by Derbyshire Health United (DHU).

Overall inspection

Good

Updated 13 April 2020

We carried out a desk-top focused review at College Street Medical Practice on 16 March 2020.

The practice previously had a comprehensive inspection in November 2016 when it received an overall rating of good, although the caring domain was rated as requires improvement. All population groups were rated as good with the exception of people experiencing poor mental health (including those with dementia) which was rated as requires improvement. This was due to some QOF indicators for mental health being lower than local and national averages, and some areas of exception reporting for mental health QOF indicators being higher than averages.

The practice received a focused inspection in August 2017 to review the caring domain and remained rated as requires improvement for providing caring services with an overall rating of good. A further focused inspection took place in September 2018 at which the practice was rated as good for providing caring services. However, the population group of people experiencing poor mental health (including those with dementia) was not reviewed at either of these two inspections and therefore the published rating was still listed as requires improvement for this population group.

This was highlighted at the practice’s Annual Regulatory Review in February 2020, and it was agreed to undertake a desk-top focused inspection to review the population group for people experiencing poor mental health (including those with dementia).

We undertook this desk based review on 16 March 2020 to check that the provider had completed the areas identified as requiring improvement. We did not visit the practice as part of this inspection.

This report only covers our findings in relation to the population group for people experiencing poor mental health (including those with dementia). You can read the report from our last comprehensive inspection and the subsequent focused inspections, by selecting the 'all reports' link for College Street Medical Practice on our website at

The practice remains rated as good overall; the population group of people experiencing poor mental health (including those with dementia) is also now rated as good. This was because:

  • QOF outcomes relating to mental health had improved and were in alignment with local and national averages
  • Levels of exception reporting had mostly decreased and were in line with averages.
  • We found that the practice was providing effective and responsive care for patients experiencing poor mental health (including those with dementia).

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

People with long term conditions

Good

Updated 6 February 2017

The practice is rated as good for the care of people with long-term conditions.

  • The practice operated a streamlined recall system which combined appointments for patients with stable multiple chronic diseases into one or two review appointments in a year. This enabled patients to attend a single longer appointment and reduced non-attendance.

  • Nursing staff had lead roles in chronic disease management with additional qualifications obtained in diabetes, asthma and chronic obstructive pulmonary disease (COPD). Patients were assigned to the appropriately trained nurse to ensure they were managed effectively. Patients at risk of hospital admission were identified as a priority.

  • Anticoagulation monitoring clinics were provided twice a week from the practice. Home visits were offered to housebound and temporary patients who received anticoagulation treatment to ensure their medicines were managed appropriately.

  • QOF performance data for 2015/16 showed the practice achieved positive outcomes for most long term conditions, including asthma, chronic obstructive pulmonary disease and heart failure. The practice achieved 100% on rheumatoid arthritis, compared to the CCG average of 92% and the national average of 96%. The exception reporting rate was 0%, compared to the CCG average of 2% and the national average of 8%.

  • Longer appointments and home visits were available and offered when needed.

Families, children and young people

Good

Updated 6 February 2017

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

  • The practice worked closely with midwives, health visitors and family nurses attached to the practice. 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 Accident and Emergency (A&E) attendances. Three members of the nursing team had experience in working in paediatric A&E and used their expertise when dealing with unwell children.

  • The practice held meetings every three months with the health visitor, and also reviewed any children on a child protection plan at their clinical meetings.

  • Childhood immunisations were provided on Wednesday afternoons by the practice nurses. Performance on standard childhood immunisations was broadly in line with CCG averages. For example, rates for children under two year olds ranged from 65% to 97% (CCG range from 66% to 98%) and five year olds from 87% to 100% (CCG range from 74% to 98%).

  • Appointments were available outside of school hours with urgent appointments available on the day for children and babies.

  • The practice offered a full range of family planning services including fitting of intra-uterine devices (coil) and contraceptive implant fitting.

  • The premises were suitable for children and babies. Baby changing facilities were available and the practice accommodated mothers who wished to breastfeed.

Older people

Good

Updated 6 February 2017

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

  • The practice had 1265 patients aged over 65 years old. They offered proactive, personalised care to meet the needs of the older people in their population. For example, patients with visual or hearing problems were flagged on the computer system when they arrived for their appointments so that a clinician seeing them came to call them in person in the waiting room.

  • GPs and nurses were responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

  • Nationally reported data showed outcomes for conditions commonly found in older people were overall good. For example, performance on osteoporosis indicators was 100%, compared to the CCG average of 94% and the national average of 87%.There were no patients exception reported for these indicators, compared to the CCG exception reporting average rate of 7% and the national average of 15% (The exception reporting rate is the number of patients which are excluded by the practice when calculating achievement within QOF).

  • Shingles vaccinations were offered to eligible patients including those over 70 years old.

  • All patients above 75 years old had a named GP for continuity of care.

  • There were 18 patients on the palliative care register. The practice worked proactively with the multi-disciplinary healthcare team to ensure patients were supported in line with the gold standard framework for palliative care.

Working age people (including those recently retired and students)

Good

Updated 6 February 2017

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. This included access to telephone appointments.

  • Early morning appointments with the health care assistant and nurses were available from 8am for working patients, and extended opening hours were provided until 8pm on Wednesday evenings.

  • The practice was proactive in offering online services such as online prescription requests, appointments, and accessing medical records.

  • There was a full range of health promotion and screening information in the practice that reflects the needs for this age group. Self-referral was encouraged for accessing services such as psychological therapies.

  • The practice’s uptake for cervical screening for eligible patients was 80%, which was slightly lower than the CCG average of 84% and the national average of 82%.

  • Breast and bowel cancer screening data was broadly in line with CCG and national averages. For example, the proportion of patients who were screened for bowel cancer within six months of invitation was 55%, compared with a CCG average of 62% and a national average of 58%.

People whose circumstances may make them vulnerable

Good

Updated 6 February 2017

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. There were 714 who were flagged on the computer system to inform staff that the patients may need extra support.

  • There were 50 people on the learning disabilities register and 76% had their care reviewed in a face to face meeting in the last 12 months. Staff told us they worked closely with the community learning disabilities specialist nurse to ensure their registers were up to date and no patients were missed.

  • 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. For example, the practice coordinated with the district nursing team for a housebound patient with learning disabilities to ensure the patient had the appropriate treatment at home.

  • 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. 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.

  • Staff told us they were aware of how to access interpreting for their patients with hearing impairment and an interpreter could be arranged for those who could not speak in English through a translation service.

  • The practice’s computer system alerted GPs if a patient was also a carer.  There were 117 patients on the carers register (1.7% of the practice list), and 36 of them had received a health check.