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The Family Doctors Good Also known as Dr C A Clyde

Inspection Summary


Overall summary & rating

Good

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Family Doctors on 26 January 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

  • There was an open and transparent approach to safety and an effective system was in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
  • Patients were positive about access to the service. They said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
  • The practice had good facilities and was well equipped to treat and meet the needs of patients.
  • The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient reference group.
  • Information about services and how to complain was available and easy to understand.
  • There was a clear leadership structure and staff were supported by management.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

  • The practice had good links with the local community. They had undertaken a coffee morning to focus on raising awareness of dementia and actively engaged with local groups in providing additional support for patients.
  • The GP and nursing staff did ‘pop in’ home visits for patients who they may have had concerns about or were vulnerable, to ensure they were safe and receiving the care and support they needed.

However, there was one area of practice where the provider should make improvements:

  • Maintain a record of all portable appliances which require testing and/or calibration to ensure all equipment is tested in line with health and safety guidance.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 17 March 2016

The practice is rated as good for providing safe services.

  • Risks to patients were assessed and well managed.
  • There was a system in place for reporting and recording significant events.
  • There was a nominated lead who looked at the reporting mechanisms, safety issues and where improvements could be made in patient safety and experience. Lessons were shared to ensure action was taken to improve safety in the practice.
  • There was a nominated lead for safeguarding children and adults and systems, processes and practices were in place to keep patients and staff safeguarded from abuse.
  • There were processes in place for safe medicines management, which included emergency medicines.
  • We checked a sample of portable appliances and equipment and saw they had been tested and/or calibrated, however some had different dates and the practice did not keep a record to ensure all equipment had been tested.

Effective

Good

Updated 17 March 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were at or above average compared to both local and national figures.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of people’s needs, for example, the community matron, district nursing and health visiting teams.
  • The practice utilised the patient information boards in the reception area and had monthly themes throughout the year, for example dementia awareness and healthy lifestyle information.

Caring

Good

Updated 17 March 2016

The practice is rated as good for providing caring services.

  • Data from the National GP patient survey showed that patients rated the practice higher than others. Patients we spoke with and comments we received were all extremely positive about the care and service the practice provided. They told us they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We observed a patient-centred culture and that staff treated patients with kindness, dignity, respect and compassion.
  • We were informed that clinicians would do ‘pop in’ home visits on any patients they had concerns about, to ensure they were safe and receiving the care and support they needed.

Responsive

Good

Updated 17 March 2016

The practice is rated as good for providing responsive services.

  • The practice reviewed the needs of its local population and engaged with the NHS England Area Team and Leeds South and East Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. For example, the Winter Pressures Scheme.
  • National GP patient survey responses and patients we spoke with said they found it easy to make an appointment.
  • All urgent care patients were seen on the same day as requested.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was an accessible complaints system. Evidence showed the practice responded quickly to issues raised and learning was shared with staff. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 17 March 2016

The practice is rated as good for being well-led.

  • There was a clear leadership structure and a vision and strategy to deliver high quality care and promote good outcomes for patients.
  • There were governance arrangements which included monitoring and improving quality, identification of risk, policies and procedures to minimise risk and support delivery of quality care.
  • The provider was aware of and complied with the requirements of the Duty of Candour. (This is a legal duty on hospital, community and. mental health trusts to inform and apologise to patients if there have been mistakes in their care that have led to significant harm.) The partners encouraged a culture of openness and honesty.
  • There were systems in place for being aware of notifiable safety incidents and sharing information with staff to ensure appropriate action was taken
  • Staff were encouraged to raise concerns, provide feedback or suggest ideas regarding the delivery of services. The practice proactively sought feedback from patients through the use of patient surveys, the NHS Friends and Family Test and the patient reference group. For example, with regard to access to the practice by telephone.
  • Staff informed us they felt very supported by the GP and practice manager. 
Checks on specific services

People with long term conditions

Good

Updated 17 March 2016

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

  • All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. The practice nurses had lead roles in long term conditions management and patients at risk of hospital admission were identified as a priority.
  • Longer appointments and home visits were available when needed.
  • The practice delivered care for patients who had diabetes or chronic obstructive pulmonary disease (a disease of the lungs) using an approach called The House of Care model. This approach enabled patients to have a more active part in determining their own care and support needs in partnership with clinicians.

  • 100% of newly diagnosed diabetic patients had been referred to a structured education programme in the last 12 months, compared to 87% locally and 90% nationally.
  • 81% of patients diagnosed with asthma had received an asthma review in the the last 12 months, compared to 75% locally and nationally.
  • Patients who required palliative care were provided with support and care as needed; in conjunction with other health care professionals.

Families, children and young people

Good

Updated 17 March 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 accident and emergency (A&E) attendances.
  • Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.
  • Appointments were available outside of school hours and the premises were suitable for children and babies. All children who required an urgent appointment were seen on the same day as requested.
  • The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example,the provision of ante-natal, post-natal and child health surveillance clinics.
  • Immunisation uptake rates were high for all standard childhood immunisations, achieving 100% for many vaccinations.
  • Sexual health and contraceptive and cervical screening services were provided at the practice.
  • 88% of eligible patients had received cervical screening, compared to 82% both locally and nationally.

Older people

Good

Updated 17 March 2016

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

  • The practice provided proactive, responsive and personalised care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients with enhanced needs.
  • The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care they needed.
  • Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission.
  • Health checks were offered for all patients over the age of 75 who had not seen a clinician in the previous 12 months.
  • The practice could identify those patients who were most at need of care and support.

Working age people (including those recently retired and students)

Good

Updated 17 March 2016

The practice is rated as good for the care of working age people (including those recently retired and students).

  • The needs of these patients had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
  • Saturday morning clinics were offered during the Winter Pressure Scheme from November 2015 until the end of March 2016.
  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. For example, cervical screening, early detection of cardio-vascular disease for patients aged 40 and above, and health checks for patients between the ages of 16 and 75 who had not seen a GP in the last three years.
  • Meningitis and measles mumps and rubella (MMR) vaccinations were offered to students prior to them commencing university. There were temporary registration facilities for students who lived away during university terms.
  • The practice offered a travel vaccination clinic.

People experiencing poor mental health (including people with dementia)

Good

Updated 17 March 2016

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

  • The practice regularly worked with multidisciplinary teams, such as the local mental health team, in the case management of people in this population group. Patients and/or their carer were given information on how to access various support groups and voluntary organisations, such as Carers Leeds.
  • 87% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, which was comparable to the local and national averages
  • All patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was higher than both the local and national average of 88%.
  • The practice had good links with the local community. They had undertaken a coffee morning to focus on raising awareness of dementia and actively engaged with local groups in providing additional support for patients.
  • Staff had a good understanding of how to support patients with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 17 March 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 and regularly worked with multidisciplinary teams in the case management of this population group.
  • Information was provided on how to access various local support groups and voluntary organisations.
  • Longer appointments were available for patients as needed.
  • Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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 GP and nursing staff did ‘pop in’ home visits for patients who they may have had concerns about or were vulnerable.