Background to this inspection
Updated
22 May 2019
Sherwood Rise Medical Centre is registered with the Care Quality Commission as a partnership consisting of three GPs, and is registered to carry out the following regulated activities - diagnostic and screening procedures, family planning, surgical procedures, maternity and midwifery services and treatment of disease, disorder or injury.
Sherwood Rise Medical Centre is situated approximately one mile from Nottingham City Centre. It has a contract with NHS Nottingham City (CCG) to provide General Medical Services (GMS) and offers a range of local enhanced services.
The practice has approximately 5,900 registered patients. The age profile demonstrates a higher proportion of younger patients, and lower numbers of older patients compared to local and national averages:
- The percentage of people in the 65+ year age group at 6.6% is below the local average of 12.2%, and the national average of 17.3%.
- The percentage of people in the under 18-year age group at 25.8% is above the local average of 22.3%, and the national average of 20.7%.
Average life expectancy is 76 years for men and 82 years for women, compared to the national average of 79 and 83 years respectively.
The general practice profile shows that 51% of patients registered at the practice have a long-standing health condition, compared to 50% locally and 51% nationally.
The practice scored two on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. Unemployment levels are high amongst registered patients at 19.2% (local 7.5%, national 4.3%). People living in more deprived areas tend to have greater need for health services.
The practice provides services to a locally diverse and multi-cultural population. The National General Practice Profile describes the practice ethnicity as being 61.9% white, 22.3% Asian, 7.4% black, 6.8% mixed race and 1.6% other non-white ethnicities.
There are three GP partners working at the practice (two females and one male). The nursing team consists of two part-time practice nurses, supported by a healthcare assistant.
The non-clinical team is led by a practice manager. The practice employs a team of eight secretarial, administration and receptionist staff.
The practice opens Monday to Friday from 8am until 6.30pm
No extended hours are available at the practice but patients have access to an extended access service (GP+) in Nottingham city centre run by Nottingham City GP Alliance, located just over a mile away. This opens from 4pm – 10pm Monday to Friday, and 9am to 1pm at weekends. There is also an urgent care centre in Nottingham open every day from 7am to 9pm.
The surgery closes on one afternoon on most months for staff training. When the practice is closed, out of hours cover for emergencies is provided by Nottingham Emergency Medical Services (NEMS).
Updated
22 May 2019
We carried out an announced comprehensive inspection at Sherwood Rise Medical Centre on 17 April 2019 as part of our inspection programme.
Sherwood Rise Medical Centre received a previous CQC inspection in May 2018 (the inspection report was published in July 2018). The practice was rated as requires improvement overall with the effective and caring domains identified as requires improvement. Two population groups were also rated as requires improvement (families, children and younger people, and working age people). This inspection did however, take the practice out of special measures.
The practice was rated as requires improvement at the last inspection because:
- Results from the national GP patient survey showed areas of lower than average satisfaction in areas relating to patient experience during consultations.
- The practice needed to improve uptake rates for childhood immunisations to meet the national target percentage of 90% or above.
- Uptake rates for breast and bowel cancer screening was below local and national averages.
- The numbers of patients identified as carers was low.
The practice was rated as good for providing safe, responsive and well-led services. The full comprehensive report (published July 2018) for this inspection can be found by selecting the ‘all reports’ link for Sherwood Rise Medical Centre on our website at www.cqc.org.uk
At this inspection on 17 April 2019, we found that the provider had satisfactorily addressed most of the previously identified concerns. However, some workstreams remained ongoing to strive towards further improvements.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good for all population groups.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs.
- The way the practice was led and managed promoted the delivery of good quality, person-centre care.
We found the following area of outstanding practice:
- Checklists to encourage attendance were devised for child immunisations, cancer screening, learning disability annual reviews, and recalls for specific conditions within the Quality Outcomes Framework (QOF). Each non-clinical member of the practice team had a defined area of responsibility to engage with patients to increase attendance rates, and this had resulted in greater compliance with treatment and minimal levels of exception reporting (patients can be exception-reported from individual indicators for various reasons, for example if they are newly diagnosed or newly registered with a practice, if they do not attend appointments or where the treatment is judged to be inappropriate by the GP such as medicines cannot be prescribed due to side-effects). This process was closely scrutinised by managers, and staff had work schedules designed to support this process.
- Both clinical and non-clinical staff were trained to level 3 in child safeguarding and level 2 adult safeguarding which exceeded guidance which specified lesser training requirements for different staff groups. The practice alternated training so that one year this was delivered face-to-face in the practice, and the following year the training was completed via an online training system which included a knowledge test. This meant that all members of the practice team had an enhanced knowledge of safeguarding.
Whilst we found no breaches of regulations, the provider shoul
d:
- Continue to review patient feedback mechanisms, particularly in relation to experience of interactions with clinicians during consultations and ensure sustainable improvements can be maintained.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care