Archived: Tunbury Avenue Surgery

Updated 16 September 2016

Tunbury Avenue Surgery is a GP practice based in Walderslade. There are 2, 252 patients on the practice list.

Services are provided at Tunbury Avenue Surgery by Sydenham House Medical Group who also provide primary medical services from other locations in the South East of England. The group took over the practice from the previous registered provider in June 2015. The practice was previously rated as inadequate and was placed in to special measures. In the six months since acquiring the practice and becoming the new registered provider for the service, Sydenham House Medical Group have implemented new systems, procedures and processes. They demonstrated clear plans for the future of the practice, prioritising patients requiring a review of their care and treatment.

The practice staff consists of one GP (male), one practice nurse (female), as well as administration staff. Also, patients can be seen by a female GP. There is a reception and a waiting area on the ground floor. All patient areas are accessible to patients with mobility issues as well as parents with children and babies.

The practice is open Monday trough to Friday 8.30am to 12.30pm and 2pm to 6.30pm. Patients requiring a GP outside of normal working hours are advised to contact the GP Out of Hours service provided by Medway On Call Care (referred to as MedOCC).

The practice has a General Medical Service (GMS) contract and also offers enhanced services.

Services are provided from:

• Tunbury Avenue Surgery, 16 Tunbury Avenue, Walderslade, Chatham, Kent, ME5 9EH.

And the branch practice at:

• Luton Medical Centre, 10a Beacon Hill, Chatham, Kent, ME5 7JX.

Updated 16 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tunbury Avenue Surgery on 17 November 2015. Breaches of the legal requirements were found, in that:

The practice did not have a defibrillator in order to respond to cardiac emergencies. The practice also did not have a risk assessment to show why a defibrillator was deemed not necessary.

As a result, care and treatment was not always provided in a safe and well-led way for patients. Therefore, Requirement Notices were served in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation12 - Safe care and treatment.

Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches and how they would comply with the legal requirements, as set out in the Requirement Notices.

We undertook this desk based inspection on 2 August 2016, to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Tunbury Avenue Surgery on our website at www.cqc.org.uk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 February 2016

The practice is rated as good for the care of people with long-term conditions. The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• 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 medicine 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.

Updated 4 February 2016

The practice is rated as good for the care of families, children and young people. The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• 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.

• Patients told us that children and young people were treated in an age-appropriate way, 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 4 February 2016

The practice is rated as good for the care of older people. The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits, even out of hours, if necessary as well as rapid access appointments for those with enhanced needs.

• The practice had daily contact with district nurses and participated in monthly or quarterly meetings with other healthcare professionals to discuss any concerns.

Updated 4 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• 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 offered a full range of health promotion and screening that reflects the needs of this age group.

Updated 4 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• All patients experiencing poor mental health had received an annual physical health check.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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.

• It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

• Staff had received training on how to care for people with mental health needs and dementia.

Updated 4 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The provider was rated as requires improvement for providing safe care. The concerns which led to this rating apply to everyone using the practice, including this population group. The provider was rated as good for providing effective, caring, responsive and well-led services.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability. The practice were carrying out annual health checks for all patients with a learning disability. Where patients had declined or requested a check at a later date, this had been clearly recorded in the patients’ record. It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff had been trained 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.