The Grantham Practice

Updated 3 April 2020

Grantham Surgery is located at:

Beckett House

Grantham Road

London

SW9 9DL

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 at one location.

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 is in an area with a mixed demographic with a diverse population consisting of 66 different nationalities represented 25-30% are Portuguese Speaking ,10% are West African (French and English) and transient mobile young population. The practice reported high levels of deprivation, poor education and housing challenges.

The practice has three GP partners, five associate GPs, two practice nurses with a mix of male and female clinical staff. The rest of the team consist of a practice manager and an extensive administrative team consisted of reception staff and a medical secretary. The practice also benefits from having other community health workers on site such as, dietician, phlebotomist, midwife, interpreters and a PCN social prescribing link worker.

The practice is open between 8:00am and 6:30pm Monday to Friday. The practice also offers extended hours four evenings a week and one morning.

The out of hours services are provided by an alternative provider. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

Updated 3 April 2020

We decided to undertake an inspection of The Grantham Surgery, following our annual review of the information available to us.

This inspection focused on the key questions Effective, Responsive and Well-led.

Because of the assurance received from our review of information we carried forward the ratings for the key questions safe and caring.

We rated the practice as Good overall with the following key question ratings:

Effective – Requires Improvement

Responsive- Outstanding

Well-led – Good

The practice had previously been inspected on 31 March 2016 and had been rated as good overall, with responsive rated as outstanding.

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 good 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 care to members of the Portuguese community, Ghanaian communities and across all patient groups.

We rated the practice as requires improvement for providing effective services because:

• 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.
• However, some patients outcomes relating to Families, children and young people and the Working age people were low.

We rated the practice as good for providing well-led services because:

• The leadership, governance and culture promoted the delivery of high-quality person-centred care.

Whilst we found no breaches of regulations, the provider should:

• Improve the uptake of childhood immunisations and cervical screening.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCG

Chief Inspector of Primary Medical Services and Integrated Care.

Updated 2 August 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was similar to the national average. Total QOF achievement for diabetic indicators was 84%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice had highlighted that 10% of the population were from Ghana, with a large number from Kumasi, and many patients travelled back to the country on a frequent basis. They had worked to develop a co-operative service with a doctor in Kumasi who had travelled to the practice to develop shared care for these patients. In particular, the practice had developed shared care diabetic protocols with the practice. This allowed patients continuity of care when out of the country.

Updated 2 August 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 77 %, which was comparable to the CCG average of 75% and the national average of 74%.

• 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 2 August 2016

The practice is rated as good for the care of older people.

• 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.

• The practice provided named GPs for older patients.

Updated 2 August 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 reflects the needs for this age group.

Updated 2 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 78% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• Performance for mental health related indicators was similar to the national average. Total QOF achievement for mental health related indicators was 84%. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 90%, similar to the national average of 88%.

• 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 in place 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 2 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a 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.