St Peter's Surgery

Updated 22 November 2017

St Peters Surgery occupies a converted bungalow in a residential area of Broadstairs, North East Kent. The practice has approximately 4500 registered patients.

The practice is owned and managed by GP partners (one female, one male). They are supported by three practice nurses (female) and two healthcare assistants (female) and an administrative team overseen by a practice manager.

The practice offers a range of services and clinics including; asthma, diabetes and child surveillance clinics.

An out of hours service is provided by Primecare, outside of the practices opening hours. There is information available to patients on how to access this at the practice, in the practice information leaflet and on the website.

Services are delivered from:

6 Oaklands Avenue, Broadstairs, Kent, CT10 2SQ.

Updated 22 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Peters Surgery on 29 November 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for St Peters Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on12 October 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 29 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 now rated as good.

Our key findings were as follows:

• The practice was able to demonstrate that the system for reporting, recording and learning from significant events was consistently and effectively implemented
• Medicines management procedures had been reviewed to ensure an effective process for managing medicine alerts from the Medicines and Healthcare products Regulatory Agency (MHRA).
• Blank prescription forms and pads were securely stored with a system to monitor their use.
• Risk assessments and management activities included all potential and actual risks to patients, staff and visitors and recommendations and actions were implemented in a timely manner.
• Recruitment checks were carried out for all members of staff including locum GPs.
• Staff received appropriate support through regular appraisals.
• Staff received ongoing training appropriate to their role including fire safety training.
• There were systems to help ensure the safety of services. For example, the recording of fire evacuation rehearsal procedures and the checking of emergency equipment.
• The practice had a system to monitor and record the hepatitis B status of GPs and nurses.
• The practice was not based in a purpose built building. However, the entrance doorways were wheelchair accessible, the doors opened inwards when pushed and there was a bell to attract the attention of reception staff.
• The practice had identified an increased number of patients as carers. There were 80 patients on the carers register, almost 2% of the patient list.
• Information regarding how to make a complaint was displayed in the patient waiting area.
• The practice were aware of patients waiting 15 minutes or less for their appointments. They responded by routinely asking patients to telephone before their appointments in order to ascertain waiting times at the practice and had an action plan to audit appointments. Conversely, 96% of respondents to the GP patient survey published July 2017 found that their GP appointment provided enough time, compared to 86% at CCG and national average. 95% of respondents were able to make an appointment with their preferred GP compared to the CCG average of 64% and the national average of 56%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetic related indicators was better than local and national averages.
• Home visits were available when needed and longer appointments on request.
• All these patients had a named GP and received a structured annual review to check their health and medicines needs were being met.
• Patients with the most complex needs were discussed by their named GP and relevant health and care professionals to deliver a multidisciplinary package of care.
• Patients had access to cardiology clinic once a fortnight led by a GP partner.

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• There were systems to identify and follow up on children living in disadvantaged circumstances and who were at risk.
• Child immunisation rates were relatively high for all standard immunisations.
• Patients and staff told us children and young people were treated in an age appropriate way and were recognised as individuals
• The practices uptake for the cervical screening programme was better than the local and national averages.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 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 and urgent appointments for those with enhanced needs.
• Patients 75 years and older received comprehensive personalised care plans.

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The needs of the working age population, those recently retired and students and been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• The practice operated extended opening hours Monday from 7.30am to 8am and from 6.30pm to 8pm for working patients who could not attend during normal opening hours.

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 100% of patients diagnosed with dementia had received a face to face care review meeting in the last 12 months, which was better than the local average of 81% and the national average of 84%.
• Performance for mental health related indicators were better than local and national averages.
• 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 an understanding of how to support patients with mental health and dementia.

Updated 22 November 2017

The provider had resolved the concerns for safety, effectiveness, responsive and well-led identified at our inspection on 29 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice held a register of patients living in vulnerable circumstances including carers, poor mental health needs and those with 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.