The Chestnuts Surgery

Updated 6 April 2017

The Chestnuts Surgery is situated in Sittingbourne, Kent and has a registered patient population of approximately 9,440. There are more patients registered between the ages of 55 and 85+ years than the national average.

The practice staff consists of four GP partners (three male and one female), one salaried GP (female), one practice manager, one deputy practice manager, three practice nurses, one healthcare assistant as well as administration and reception staff. There are reception and waiting areas on the ground floor. The practice also employs locum GPs via an agency. Patient areas on the ground floor are accessible to patients with mobility issues, as well as parents with children and babies.

The practice is not a teaching or training practice (teaching practices have medical students and 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 70 East Street, Sittingbourne, Kent, ME10 4RU only.

The Chestnuts Surgery is open Monday to Friday between the hours of 8am to 12.30pm and 1.30pm to 6pm. Extended hours appointments are offered Monday to Friday 7am to 8am. 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 (Medway On Call Care) to deliver services to patients outside of the practice’s working hours.

Updated 6 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chestnuts Surgery on 26 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for The Chestnuts Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 February 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 26 July 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 had revised the system that managed and recorded actions taken as the result of receiving national patient safety alerts.

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

• The practice had revised clinical audit activity to help ensure it was driving quality improvement.

• The practice had made improvements to help ensure staff maintained accurate, complete and contemporaneous records in respect of each service user.

• The practice had introduced systems to help ensure results were received for all samples sent for the cervical screening programme as well as to help ensure women who were referred as a result of abnormal results were followed up.

• The practice had introduced a system that identified patients who were also carers. The practice had identified 28 patients on the practice list who were also carers.

• Governance arrangements had been revised to help ensure they were effectively implemented.

• The practice had introduced a system to help keep all governance documents up to date.

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

In addition 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 April 2017

The provider had resolved the concerns for the provision of safe, effective and well-led care identified at our inspection on 26 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Updated 6 April 2017

The provider had resolved the concerns for the provision of safe, effective and well-led care identified at our inspection on 26 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Updated 6 April 2017

The provider had resolved the concerns for the provision of safe, effective and well-led care identified at our inspection on 26 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Updated 6 April 2017

The provider had resolved the concerns for the provision of safe, effective and well-led care identified at our inspection on 26 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Updated 27 September 2016

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

• 96% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the local clinical commissioning group (CCG) average of 83% and national average of 84%.
• 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 national average of 88%. 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 national average of 90%.
• 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 April 2017

The provider had resolved the concerns for the provision of safe, effective and well-led care identified at our inspection on 26 July 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.