The Care Quality Commission
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  • GP practice

Archived: Nelson Medical Practice

Overall: Good read more about inspection ratings

Pasteur Road, Great Yarmouth, Norfolk, NR31 0DW (01493) 419600

Provided and run by:
East Coast Community Healthcare C.I.C.

Important: This service was previously managed by a different provider - see old profile
Important: The provider of this service changed. See new profile

All Inspections

27 July 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Nelson Medical Practice on 27 July 2017. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events at practice and provider level.
  • The practice had some defined and embedded systems to minimise most risks to patient safety. However, the system to ensure patients had received their medicines needed to be improved as we found prescriptions that had not been collected since February 2017.
  • The daily check list for emergency medicines was incomplete; however all medicines were in date.
  • Exception reporting for the Quality and Outcomes Framework (QOF) was high compared to local and national averages and uptake for breast and bowel screening was low. The practice were aware of this and had a policy and plan in place to address this.
  • Results from the GP patient survey, published in July 2017, below average for several aspects of care. Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • The practice had identified 240 patients as carers (3.8% of the practice list).
  • 30% of the practice population did not have English as a first language. The practice had recognised this and provided documents in different languages.
  • The practice had a ‘care connector’ who went to local meetings with voluntary groups and helped to sign post patients to relevant local services.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • The infection prevention and control lead completed three monthly audits of room cleaning to ensure compliance.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management and East Coast Community Healthcare (ECCH). The practice proactively sought feedback from staff and patients, which it acted on. However, the practice had recently lost a clinical lead and were being supported by ECCH until a new lead was appointed.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

We saw one area of outstanding practice:

  • The practice held an information event in March 2017 to encourage fitness in patients registered at the practice. The practice had recognised that access to and involvement in exercise for their population group was limited. 60 patients attended the event and 58 signed up to the five week exercise plan. 38 patients had completed the 5 week plan and this enabled them to gain a free gym membership. This was an initiative of, and was funded by ECCH and had improved health outcomes for patients. ECCH hoped to run this event again.

The areas where the provider should make improvements are:

  • Review the system for managing uncollected prescription scripts.

  • Embed the policy and plan to reduce exception reporting ensuring that patients received appropriate follow ups.

  • Review the system for the checking of emergency medicines.

  • Continue to build on clinical leadership and active recruitment.

  • Continue to monitor the effectiveness of actions taken in response to national GP Patient Survey, particularly in relation to patients’ access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 October 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Nelson Medical Practice on 18 February 2016. We found areas where requirements were required.

We found that effective procedures were not in place for reporting, recording, acting on and monitoring complaints, in order to ensure they are fully investigated, complainants are responded to and ensure reflective and shared learning.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to ensuring robust processes were in place.

We undertook this focused desktop inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

The overall rating for the practice is good. You can read our previous report by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 February 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Nelson Medical Practice on 18 February 2016. Overall the practice is rated as good.

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 in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based 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 they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice;

  • In response to the high rates of teenage pregnancy rates in the area, one GP had trained to fit intrauterine coil devices and implants. Largely as a result of this, the number of teenage pregnancies had steadily dropped from 24 from April 2010 to March 2012, to18 from March 2014 to February 2016 a reduction of 25%

The areas where the provider must make improvement are:

  • Implement processes for reporting, recording, acting on and monitoring complaints to ensure they are fully investigated and complainants are responded to and ensure reflective and shared learning.

The areas where the provider should make improvement are;

  • Ensure annual reviews for patients with a learning disability, patients with a mental health issue and patients with dementia are undertaken in a timely way

  • Continue to promote and advertise for members of the Patient Participation Group (PPG).

  • Ensure systems and procedures to improve the provision of service to nursing and care homes are embedded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

31 October 2013

During a routine inspection

We spoke with two people who used the service. Both were satisfied with the service provided. We also inspected the results of the recent patient survey and compliments receieved by the service. People had commented, " I can only say that I am satisfied with everything" and "The doctor was absolutely fantastic."

We saw that the building was clean and well maintained. There were appropriate maintenance and cleaning schedules in place.

Staff employed by the service had undergone the appropriate checks before being offered employment which had included checks of their professional qualifications.

16 April 2013

During an inspection looking at part of the service

When we carried out a routine inspection of this service on 6 March 2013 we found that people were not always protected against the risks associated with the storage of medicines. This was because appropriate storage arrangements were not in place.

We carried out a follow up inspection on the 16 April 2013 to ensure that the service had put the correct measures in place in relation to the storage of medicines.

We found that medicines were now stored safely because the emergency trolley was secured in a clinical room and a new system was in place to store the keys to the clinical rooms. We also found that clinical rooms and the fridge containing medications were now kept locked. This meant that people were safe because medicines were stored safely.

6 March 2013

During a routine inspection

During our inspection we spoke with four people who used the service and four members of staff. We also reviewed five sets of documentation to check that people's consent was gained for their treatment.

We found that people who used the service understood the care and treatment choices available to them. One person we spoke with told us, 'Excellent service ' they always explain everything properly like the side effects.' Another person told us, 'The nurses here are fantastic. They always explain and I feel happy to ask questions.'

People who used the service were given appropriate information and support regarding their care or treatment. We also found that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw that there were effective systems in place to reduce the risk and spread of infection. We found that staff received appropriate professional development. Also, staff were able from time to time, to obtain further relevant qualifications.

People were made aware of the complaints system and this was provided in a format that met their needs.

We found that emergency medicines were not always kept safely. People were at risk because medicines were stored in an unlocked room on a shelf in a trolley accessible to people in the waiting area.