Rock Court Surgery

Updated 7 November 2016

Rock Court Surgery is responsible for providing primary care services to approximately 4621 patients. The practice has a General Medical Services (GMS) contract and offers a range of enhanced services such as flu and shingles vaccinations, unplanned admissions and timely diagnosis of dementia. The number of patients with a long standing health condition is about average when compared to other practices nationally. The practice has three GP partners, one practice nurse and health care assistant, administration and reception staff and a practice manager.

The practice is open from 8am to 6.30pm Monday to Friday. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services. Home visits and telephone consultations are available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients receive urgent medical assistance out of hours when the practice is closed.

The practice is part of the Liverpool Clinical Commissioning Group (CCG) and is within the Tuebrook and Stoneycroft neighbourhood, where the practice is placed in the eight most deprived in the city and has a birth rate above the Liverpool average. Unemployment is significantly higher than the city rate (7.8% compared to 7.2%) and 7% of the population are long term sick or disabled. People living in more deprived areas tend to have greater need for health services.

Updated 7 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rock Court Surgery on 28 September 2016. Overall the practice is rated as good.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.We saw good evidence of improving the service by learning from adverse events and errors. Improvements were evident when patient complaints had been made.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.

• Feedback from patients (on the day of inspection) about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

There were also areas of practice where the provider should make improvements as follows:

• A system should be in put place to enable the practice nurse to receive appropriate clinical supervision and support.

• The practice should undertake a legionella risk assessment for the building.

• Regular infection control audits should be undertaken.

• The practice should develop a business continuity plan for major incidents such as power failure or building damage.

• The practice should review the guidelines and best practice information to ensure staff have access to the most up to date information at all times.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 November 2016

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions. The practice nurse and health care assistant (HCA) had a system for annual reviews with the support of a dedicated administration support officer to ensure all patients are invited in for their annual review. The clinical staff took the lead for different long term conditions and kept up to date in their specialist areas. The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice nurse worked with the CCG medicines management team to offer individual reviews to patients with long term conditions. The practice referred patients who were over 18 and with long term health conditions to a well-being co-ordinator for support with social issues that were having a detrimental impact upon their lives.

Updated 7 November 2016

The practice is rated as good for the care of families, children and young people. The practice liaised regularly with the Health Visitor to review children under five years of age, which included vulnerable children and those newly registered at the practice. Child health surveillance and immunisation clinics were provided. The practice had a reminder system for parents who did not bring children and babies for immunisation, sending these letters out in their native language whenever possible. Appointments for young children were prioritised. The staff we spoke with had appropriate knowledge about child protection and how to report any concerns. The safeguarding lead staff liaised with the health visiting service, school nurses and midwife to discuss any concerns about children and how they could be best supported. The practice provided a comprehensive and confidential sexual health and contraceptive service delivering the full range of contraceptive services.

Updated 7 November 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. All patients over 75 years old had a named GP, who oversaw their care. The practice maintained a register for housebound and nursing home patients. An alert was added to the practice system to inform all staff that the patient was housebound, when required, these patients were visited at home in a timely manner. The practice accessed community services for elderly patients when necessary, including the respiratory team, domiciliary phlebotomy and the psycho geriatrician. During this past year the practice had a pharmacist available to complete discharge medication reviews for patients with complex needs. The practice participated in the Unplanned Admissions initiative and a proportion of patients involved were over 75 years. All of those participating in the service had a care plan in place, a named GP and were reviewed regularly. There were a variety of methods used for the ordering of repeat prescriptions, and the practice worked in conjunction with local pharmacies to ensure older people found repeat prescription ordering more accessible and convenient.

Updated 7 November 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had 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 reflected the needs for this age group. The practice had an active website as well as noticeboards in reception advertising services to patients.

Updated 7 November 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients receiving support with their mental health. These patients were mostly known by receptions staff and we saw they would call patients to remind them an appointment had been booked for them. Patients experiencing poor mental health were offered an annual review. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression. Clinical and non-clinical staff had undertaken training in dementia to ensure all were able to appropriately support patients. The practice screened patients for dementia and would refer to the appropriate service. The practice worked with the local mental health team and regularly met with a mental health liaison practitioner.

Updated 7 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. There was a recall system to ensure patients with a learning disability received an annual health check and at the time of the inspection the practice was reviewing this patient register and the quality of care with the help of a primary care facilitator. The staff we spoke with had appropriate knowledge about adult safeguarding and how to report any concerns. Services for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. The practice provided a service to a local hostel, often these patients were vulnerable and required extra support for such matters as mental health issues, drugs, alcohol, finances and housing benefits. The practice had established links with Mersey Care and named Consultants, with regular clinical meetings and good communications taking place via email for advice. The practice worked with the Citizen Advice Bureau to improve outcomes for some patients who are suffering from anxiety relating to financial or employment difficulties. These patients were provided with advice from benefits advisers and debt counsellors to help address their problems. The practice also issued tokens for the local food bank to patients in need of support.