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Bridge House Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 30 July 2015

Letter from the Chief Inspector of General Practice

We inspected this service on 5 March 2015 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

  • Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.

  • There were systems in place to keep patients safe from the risk and spread of infection.

  • Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.

  • The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 30 July 2015

The practice is rated as good for providing safe services. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Risks to patients were assessed and well managed. There were robust safeguarding measures in place to help protect children and vulnerable adults. Reliable systems were in place that ensured the safe storage and use of medicines and vaccines within the practice. There was a designated lead to oversee the hygiene standards within the practice to prevent infections. There were enough staff to keep people safe.

Effective

Good

Updated 30 July 2015

The practice is rated as good for providing effective services. Clinicians worked to the National Institute for Health and Care Excellence (NICE) guidelines and other locally agreed guidelines. NICE is the organisation responsible for promoting clinical excellence and cost-effectiveness. They produce and issue clinical guidelines to ensure that every NHS patient gets fair access to quality treatment.

Patients’ needs were assessed and care planned and delivered in line with current legislation. Clinicians had carried out clinical audits and made changes where necessary to promote effective treatments for patients. Systems were in place for regular reviews of patients with long term conditions, those identified as at risk and housebound patients. Staff had received training appropriate to their roles and any further training needs had been identified and planned. The practice could show that appraisals and personal development plans had been completed for all staff. Staff worked well with multidisciplinary teams.

Caring

Good

Updated 30 July 2015

The practice is rated as good for providing caring services. Patients were treated with compassion, dignity and respect and were involved in decisions about their care and treatment. Information to help patients understand the services available to them was easy to understand. We also saw that staff treated patients with kindness and respect and maintained confidentiality. We observed a patient-centred culture. Staff were motivated and inspired to offer kind and compassionate care.

Responsive

Good

Updated 30 July 2015

The practice is rated as good for providing responsive services. The practice understood the needs of the population groups registered with them and were proactive in planning services to meet their needs. Patients told us they could get an appointment with a named GP or a GP of their choice, with urgent appointments available the same day. The practice had good facilities and was well equipped to assess and treat patients in meeting their needs. Information about how to complain was available and easy to understand and the practice responded quickly when issues were raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 30 July 2015

The practice is rated as good for being well-led. The practice prioritised the provision of quality and caring services for all their patients. All practice staff worked together to achieve this. Staff had received regular performance reviews and attended staff meetings and events. An induction procedure was in place for implementation when new staff were employed to work at the practice. There was a clear management structure and staff told us they felt there was strong leadership at the practice.

Patients told us that the practice was always supportive and provided excellent care to meet the healthcare needs of patients. The practice had responded to feedback from patients and staff about ways that improvements could be made to the services offered that would be of benefit to both the practice and its patients.

Checks on specific services

People with long term conditions

Good

Updated 30 July 2015

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 people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 30 July 2015

Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered extended hours appointments for two mornings and two evenings a week for advanced booking. The practice also offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice, viewing medical record and updating patient details.

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 attendances at the accident and emergency (A&E) department of the local hospital.

Older people

Good

Updated 30 July 2015

The practice offered personalised care to meet the needs of the older people within its population. They provided a range of enhanced services such as dementia and end of life care. Nationally reported data showed that the practice performed well against indicators relating to the care of older people. For example, the practice maintained a register of patients in need of palliative care and held weekly multidisciplinary care meetings where all patients on the palliative care register were discussed.

The practice was responsive to the needs of older patients. They offered home visits and rapid access appointments for those with complex healthcare needs. Patients 75 years of age and over were offered annual health reviews. The practice had recently employed a nurse care coordinator for two days per week to oversee and coordinate the care of patients 75 years of age and over. This service had been developed in recognition of the higher than average number of elderly and frail patients registered with the practice.

Working age people (including those recently retired and students)

Good

Updated 30 July 2015

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. The practice was proactive in offering on-line appointments and repeat prescription services, as well as a full range of health promotion and screening clinics that reflected the needs of this age group.

The practice offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice and updating patient details. The practice nurse had oversight for the management of a number of clinical areas, including immunisations, cervical cytology and some long term conditions. The healthcare assistant led the smoking cessation clinic in the practice.

People experiencing poor mental health (including people with dementia)

Good

Updated 30 July 2015

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 and dementia. It had carried out annual health checks for patients with a learning disability and most of these patients had received a follow-up. It offered longer appointments for these patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It confirmed that vulnerable patients were informed 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 both normal working hours and out-of-hours.

People whose circumstances may make them vulnerable

Good

Updated 30 July 2015

The practice held a register of patients living in vulnerable circumstances including people with a learning disability. The practice was committed to meeting the needs of vulnerable people and provided a caring and responsive service for them. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments and offered additional attention such as longer appointments.