Background to this inspection
Updated
29 March 2019
The Adam Practice is located at 306 Blandford Road, Hamworthy, Poole, Dorset BH15 4JQ.
There are branch sites at:
Poole Surgery
117 Longfleet Road
Poole
Dorset BH15 2HX
Telephone: 01202 676111
Upton Surgery Upton Cross
Poole
Dorset BH16 5PW
Telephone: 01202 622339
Heath Cottage Surgery
40 High Street
Lytchett Matravers
Dorset
BH16 6BG
Telephone: 01202 632764
The practices have an NHSE personal medical services (PMS) contract to provide health services to approximately 32,573 patients (this is across the four practices and patients can visit any they wish to).
The practice is registered with the CQC to carry out the following regulated activities - diagnostic and screening procedures, surgical procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.
The practice has opted out of providing out-of-hours services to their own patients and refers them to an out of hour's provider via the NHS 111 service. This information is displayed on the outside of the practice, on their website, and in the patient information leaflet.
Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The majority of patients describe themselves as white British.
The mix of patient's gender (male/female) is almost 50% each. 2.7% of the patients are aged over 85 years old which is lower than the local average (CCG) of 3.9% but similar to the national average of 2.2%.
There are a total of 22 GPs working at the practice. 16 of the GPs are partners who hold managerial and financial responsibility for running the business (this equates to eight whole time equivalent GP partners (nine male and seven female). The permanent GPs are also supported by six salaried GPs. The GPs are supported by a practice manager, a practice pharmacist, four advanced nurse practitioners, 15 practice nurses, two health care assistants, four nursing assistants and a research nurse. In addition, there are two practice nurses and a health care assistant within The Adam Practice Admission Avoidance Service and administration and reception staff.
Updated
29 March 2019
We carried out an announced comprehensive inspection at The Adam Practice on 23 and 24 January 2019 as part of our inspection programme.
We based our judgement of the quality of care at this service is 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 outstanding overall.
We rated the practice as outstanding for providing responsive services because:
- Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
- There were innovative approaches to providing integrated person-centred care.
- The practice had identified areas where there were gaps in provision locally and had taken steps to address them.
We rated the practice as outstanding for providing well-led services because:
- The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
We rated the population groups: Older people; Families, children and young people; and People whose circumstances may make them vulnerable as outstanding.
We also rated the practice as good for providing safe, effective and services because:
- Feedback from patients was consistently positive and was higher than local and national averages.
- There was a strong person-centred culture.
- 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.
We saw several areas of outstanding practice including:
- The Adam Practice had an established service and team for their frail population called TAPAAS (The Adam Practice Admission Avoidance Service). The team visited older and frail patients to provide additional clinical and social support, including onward referral and signposting to enable patients to remain in their homes and retain a good quality of life. The nurse manager of the practice was leading a project to coordinate similar teams across the Poole Central Network to share best practice and focus resources in the most effective way.
- The Best Foot Forward Leg Club service has moved to larger premises to cater for more patients, and included armchair exercises for those who attend. The nurse manager who set up the leg ulcer club has received a Queen’s Nurses Award for this work. They have also written reflective accounts for nursing publications.
- There was an efficient executive structure in place for the operational organisation of the practice that ensured high quality care and development of the service provided. There were clear constitutions on what could be discussed at operational and partner meetings which enabled clear lines of responsibility and accountability. All actions from meetings were captured on an overall plan for the practice and action plans with monitoring systems were in place.
- The ethos of the practice was to put patients at centre of their care and treatment. Throughout the inspection visit staff demonstrated the ethos and values of the practice. For example, when talking about the service provided for patients; staff spoke about the need to engage patients in their care and treatment, and prioritise according to patient wishes, whilst managing risk.
Whilst we found no breaches of regulations, however the provider should:
- Review systems for ensuring that training records are up to date.
- Review processes to improve the number of carers identified.
- Continue to review systems for promoting cervical screening uptake.
- Review arrangements to make sure health and safety risk assessments are carried out at all sites in line with practice policy.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice