Archived: Burseldon Surgery

Updated 14 May 2018

Dr Vivian Ding is the solo registered provider of Bursledon Surgery located at The Lowford centre, Portsmouth Road, Lowford, Southampton, Hampshire, SO31 8ES.

There is one female GP who is also the provider and there is one male salaried GP. The practice has an advanced nurse practitioner, a practice nurse, a health care assistant and a phlebotomist. The practice is supported by a practice manager and a reception and administration team.

Bursledon Surgery provides services for approximately 3,850 patients and there is a slightly higher than average number of patients aged four years and under; and aged 30-34 years old.

The practice is open between 8.30am and 6.30pm Monday to Fridays. Appointments are available between these times daily, extended hours appointments are offered early mornings on Mondays and Wednesdays and evenings on Thursdays. When the practice is closed patients are advised to dial the NHS 111 service for the out of hours services.

We visited the only location at this inspection.

Updated 14 May 2018

We carried out an announced comprehensive inspection at Bursledon Surgery on 20 April 2017. The overall rating for the practice was good, with the well led domain rated as requires improvement. The population group for people whose circumstances make them vulnerable was rated as requires improvement. The full comprehensive report for 20 April 2017 can be found by selecting the ‘all reports’ link for Bursledon Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 26 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in April 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At our previous inspection we made recommendations with regard to sharing of learning of significant events with staff; reviewing all patient group directives for medicine administration had been signed and authorised; continuing with the remedial arrangements for Legionella testing; and reviewing the title of the form used for risk assessing whether a disclosure and barring service check was needed.

Our key findings were as follows:

• Governance arrangements had been strengthened to demonstrate how the practice was performing.

• Staff had received training on the Mental Capacity Act 2005 and were able to apply this in practice.

• Systems and processes in place enable the practice to have an oversight of its performance.

• The form used for risk assessing whether a member of staff needed to have a disclosure and barring service check had been updated to reflect what information was being requested.

• All patient group directives used by staff to authorise them to administer vaccines and immunisations had been correctly signed by the member of staff who gave the medicines and had been authorised by a GP.

• Actions related to Legionella testing and control had been completed and there was ongoing monitoring.

• Significant events had been documented and learning shared with relevant members of staff and external organisations.

Overall the practice is rated as good. The rating for the population group for people whose circumstances may make them vulnerable has also changed from requires improvement to good.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 6 July 2017

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 apriority.
• Performance for diabetes related indicators was similar to the clinical commissioning group (CGG) and national averages.Exception reporting for all diabetes indicators was lower than the CCG average of 14% and the national figure of 12%.
• For example, the percentage of patients with diabetes, on the register, in whom the last average blood glucose levels were within acceptable limits in the preceding 12 months was 79%compared to the CCG average of 67% and the national average of 68%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 6 July 2017

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.

Updated 6 July 2017

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 patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

Updated 6 July 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.
• The practice’s uptake for the cervical screening programme was71%, which was statistically comparable to the CCG average of79% and the national average of 76%.
• The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 6 July 2017

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

• 89% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 78% and the national average of 78%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive,agreed care plan documented in the record, in the preceding 12months was 62%; compared with the CCG average of 77%; and the national average of 78%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 14 May 2018

At our previous inspection this population group was rated as requires improvement, as not all staff had received training on the Mental Capacity Act 2005. They were unable to demonstrate how a patient's capacity would be assessed. We found the practice had provided training for staff and they were able to describe to us what actions they would take if needed.