Bower Mount Medical Practice

Updated 30 May 2017

Bower Mount Medical Practice is situated in Maidstone, Kent and has a registered patient population of 10,478. There are more patients registered between the ages of 40 and 44 years as well as above the age of 65 years than the national average. There are fewer patients registered between the ages of 5 and 29 years than the national average. The practice is located in an area with a lower than average deprivation score.

The practice staff consists of seven GP partners (three male and four female), one GP Registrar, one practice manager, one assistant practice manager, three practice nurses (all female), two healthcare assistant (both female), one phlebotomist as well as administration and reception staff. There are reception and waiting areas on the ground floor. There is also a waiting area on the first floor which is accessible by stairs and lift. Patient areas are accessible to patients with mobility issues, as well as parents with children and babies.

The practice is a training practice (training practices have GP trainees and FY2 doctors).

The practice has a general medical services contract with NHS England for delivering primary care services to the local community.

Services are provided from Bower Mount Medical Practice, 1 Bower Mount Road, Maidstone, Kent, ME16 8AX only.

Bower Mount Medical Practice is open Monday to Friday 8am to 6pm. Extended hours appointments are offered Friday 7am to 8am as well as once each month on Saturday 8am to 11am.

Primary medical services are available to patients via an appointments system. There are a range of clinics for all age groups as well as the availability of specialist nursing treatment and support. There are arrangements with other providers (Integrated Care 24) to deliver services to patients outside of the practice’s working hours.

During this inspection we visited Bower Mount Medical Practice, 1 Bower Mount Road, Maidstone, Kent, ME16 8AX only.

Updated 30 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bower Mount Medical Practice on 22 November 2016. The overall rating for the practice was good. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Bower Mount Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 25 April 2017 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 on 22 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice was able to demonstrate they were following guidance on the management of medicines.

• The practice was able to demonstrate that fire safety risks to patients, staff and visitors were being assessed and well managed.

• The practice had identified 91 patients on the practice list who were carers (0.9% of the practice list).

• We looked at five policy and procedure documents that governed activity at the practice and saw that they were up to date and contained a planned review date.

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

The provider should:

• Continue to identify patients who are also carers to help ensure eligible patients are offered relevant support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 February 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 a priority.

• Performance for diabetes related indicators was comparable to and below the local clinical commissioning group (CCG) average and national average. For example, 70% of the practice’s patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol.mol or less in the preceding 12 months compared with the local CCG average of 76% and national average of 78%. Eighty six percent of the practice’s patients with diabetes, on the register, had a record of a foot examination and risk classification within the preceding 12 months compared with the local CCG average of 89% and national average of 89%.
• Longer appointments and home visits were available when needed.
• All these patients had a structured annual review to check their health and medicine 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 February 2017

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

• There were systems 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 attendances.
• Childhood immunisation rates for the vaccinations given were comparable with local clinical commissioning group (CCG) averages. For example, childhood immunisation rates for the vaccinations given to five year olds ranged from 84% to 98% compared to the local CCG averages which ranged from 82% to 95%.
• 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.
• The percentage of the practice’s female patients aged 25 to 64 years who had attended cervical screening within the target period (3.5 or 5.5. year coverage) was 78%. This was comparable to the local CCG average of 78% and national average of 74%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Where possible all members of each family registered at the practice were registered with the same GP to help ensure continuity of care.
• The practice worked with midwives, health visitors and school nurses to help meet the needs of this patient population group.

Updated 6 February 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 people in its population.

• The practice was responsive to the needs of older people, and offered home visits, longer appointments and urgent appointments for those with enhanced needs.
• Patients over the age of 75 years had been allocated to a designated GP to oversee their care and treatment requirements.
• The practice provided services to patients in residential and care homes. Each home had a designated GP to help maintain continuity of patient care.

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 help ensure these were accessible, flexible and offered continuity of care.
• Extended hours appointments were offered Friday 7am to 8am as well as once each month on Saturday 8am to 11am to help meet the needs of this patient population group.
• 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.

Updated 6 February 2017

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

• 78% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was lower than the local clinical commissioning group (CCG) average of 84% and national average of 87%.
• Performance for mental health related indicators was higher than the local CCG average and national average. For example, 97% of the practice’s patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their records in the preceding 12 months compared with the local CCG average of 91% and national average of 89%. Ninety four percent of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months compared to the local CCG average of 89% and national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

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 including those with a learning disability.
• 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.
• 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.