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Archived: Thornton Practice Good

This service was previously managed by a different provider - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Thornton Family Health Clinic. Our inspection was a planned comprehensive inspection, which took place on 12 November 2014. The surgery is run by a large provider called SSP Health Ltd.

Our overall rating of the service is that it provided effective, responsive care that was rated as good. The practice is also rated as good for being well-led.

Our key findings were as follows:

  • The locum GPs had been working at the practice for some time and had built constructive working relationships with members of the community nursing teams and with the patients they provided cared for.
  • The locum GPs were familiar with governance processes. Patients commented that they valued seeing the same GP on a regular basis.
  • Regular practice meetings took place which the locum GPs attended or led on. These enhanced communication to the practice team of areas for improvement at practice.
  • Good working relationships were in place between the practice and community nursing and care teams which promoted patient welfare.
  • Care plans were in place for those patients deemed to be at risk of unplanned admissions to hospital. Patients we spoke with were able to confirm their involvement in drawing up these care plans.
  • Staff were well led by the practice manager and locum GPs. Staff were committed to providing patients with a caring service.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Review complaints about patient care and treatment using serious event analysis and investigation systems to promote learning and improve the quality of services.

In addition the provider should:

  • Improve steps to gain patient feedback, such as forming a Patient Participation Group (PPG) for the practice.
  • Ensure adequate risk assessments are in place which detail the reasoning for having or not having DBS checks completed on staff who are used to chaperone patients.
  • Provide practice level peer review and clinical supervision of GPs work.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Requires improvement

Updated 19 February 2015

The practice is rated as requires improvement for provision of safe care and treatment. Systems were in place to report, record and investigate any serious events. The process for doing this was understood and followed by staff. Lessons were learned and communicated widely to support improvement. Information about safety was monitored and shared. The practice did not treat some complaints about patient outcomes and patient care, as serious events. This meant learning opportunities were missed. The practice did not provide a system of peer review and clinical supervision of GPs work at practice level.

Effective

Good

Updated 19 February 2015

The practice is rated as

good for providing effective services. Care and treatment was delivered in line with best practice guidance. Information from a number of sources was used to drive improvement and a provider level system of clinical audit was in place to review the care and treatment delivered to patients. Data was used to provide focus on areas for improvement. Administrative and nursing staff were supported and received the training they needed to carry out their duties. Patient appointment systems were managed effectively to meet the needs of the patients.

Caring

Good

Updated 19 February 2015

The practice is rated as good for the provision of caring services. Patients we spoke to on the day of our inspection and those who had completed Care Quality Commission comment cards, described staff as being caring, respectful and thoughtful towards patients. Staff we spoke to were clear about their duty to protect confidential information. Patients told us they were offered a more private room to discuss any concerns they had if they were uncomfortable doing this at the reception desk.

Responsive

Good

Updated 19 February 2015

The practice is rated as good for the provision of responsive services. Appointment availability was reviewed on a regular basis to check for any rise in demand. Appointments could be booked on- line, in person or by phone. Staff responded quickly to any cancelled appointments so that these were made immediately available to other patients. When required, patients were offered a double appointment to allow them sufficient time with the GP to discuss their health and care needs.

Well-led

Good

Updated 19 February 2015

The service is rated as good for being well-led. The long term locum GPs and the practice manager provided clear leadership for all staff at the practice. The nursing staff worked well with other community clinicians who shared the building the practice was located in. Arrangements were in place to support any new staff through induction and to provide staff with mentors to help develop their skills.

Checks on specific services

People with long term conditions

Good

Updated 19 February 2015

The practice nurses ran effective disease management clinics. All newly registered patients completed a health questionnaire, which asked patients to highlight any long term health conditions they had. Staff used this information to update disease registers and ensure patients had access to nurse or GP appointments so their condition could be assessed. We saw that patients had regular reviews of their medication to ensure it continued to meet their needs.

Families, children and young people

Good

Updated 19 February 2015

Patients in this population group were well served by the practice. The percentage of patients registered with the practice, between the ages of 0 -19 years old was in line with the England average. The practice nurse delivered childhood vaccinations and immunisations, along with other adult immunisations. Appointments were sufficiently well managed to allow for emergency cases, for example any child that needed to be seen by a GP on that day. The practice had systems in place to capture and follow up on patients who had not attended appointments. This supported safeguarding systems in place for any child or young person that was subject to a safeguarding plan.

Older people

Good

Updated 19 February 2015

The needs of older patients were met. All patients over the age of 75 years had a named GP. Data available to us before our inspection showed that the practice had performed well in the referral of patients who had showed symptoms of dementia. The rate of patients diagnosed was significantly higher than the England average. This meant those patients who received a diagnosis could be properly treated and supported. The practice worked well with community clinicians to deliver planned care for older patients.

Working age people (including those recently retired and students)

Good

Updated 19 February 2015

The practice provided services which met the needs of this population group. Extended hours surgeries were available on one morning and one evening in the week. Staff worked hard to ensure that these appointments were used by patients who’s working or educational commitments meant they could not attend the practice in normal working hours. A range of health screening initiatives and clinics were available to patients from this group, including well man and well woman appointments with the nurse if requested.

People experiencing poor mental health (including people with dementia)

Good

Updated 19 February 2015

GPs used a recognised tool to screen patients who presented with symptoms that may indicate signs of dementia. This had led to timely referrals to the memory clinic where more detailed assessment of the patient could be conducted. GPs told us they were well supported by the community mental health teams, which were based nearby.

People whose circumstances may make them vulnerable

Good

Updated 19 February 2015

Staff maintained registers of those patients with learning disabilities. Systems were in place to ensure that these patients received regular health checks. Any patients who failed to attend planned appointments were contacted to organise a further appointment. The practice had worked to ensure continuity of care for these patients.