Garland House Surgery

Updated 15 April 2016

Dr Mellor and Partners is situated in a semi rural area on the outskirts of Barnsley in the village of Darfield. Purpose built in 2004; it has a car park and easy access throughout.

The practice provides care for 12214 patients in the NHS Barnsley Clinical Commissioning Group (CCG) area.

We also visited the branch surgery, Woodgrove Surgery. This is approximately four miles away in Wath upon Dearne, Rotherham.

The practice catchment area has been identified as one of the fourth most deprived areas nationally.

There are 8.5 whole time equivalent GPs supported by a practice manager, an assistant practice manager, two female practice nurses, three healthcare assistants and a team of administration and reception staff.

The practice opening hours and surgeries are 8.00am to 6.30pm Monday to Friday. Appointments are available all day, including lunchtime appointments. The practice provides extended hours from 7.30am to 8.00am on a Tuesday, Wednesday and Friday. Longer appointments are available for those who need them and home visits and telephone consultations are available as required. Text reminders are sent prior to appointments to patients who have signed up for this service. Pre bookable appointments are available two weeks in advance for GPs and six weeks in advance for nurses. 

Out of hours services are accessed by calling the practice telephone number or NHS 111.

The practice is registered to provide the following regulated activities; maternity and midwifery services; surgical procedures, family planning, diagnostic and screening procedures and treatment of disease, disorder or injury from Garland House Surgery, 1 Church Street, Darfield, Barnsley S73 9JX and the branch Woodgrove Surgery, 2 Doncaster Road, Wath upon Dearne, Rotherham S63 7AL.

Updated 15 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mellor and Partners on 7 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients told us that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients told us they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The registered provider was aware of and complied with the requirements of the Duty of Candour.

We saw four areas of outstanding practice:

The practice had a staff incentive scheme where staff could put forward their ideas to improve the service and if the idea worked, they were given a financial reward. For example, two members of staff designed a new form for referrals to the hospital. This was more streamlined and made it easier to capture the necessary information. This form was implemented and the staff were rewarded.

The practice worked closely with a home for people recently released from prison. Each of these patients was given an appointment with a named GP who worked together with the patient and their key worker to enable appropriate care and support to be given. Follow up was arranged and signposted to other services where necessary.

At the request of the patient participation group (PPG) all staff had received training in sensory awareness and this was shown to be beneficial for the patients. We were told that when one patient attended the practice with a white stick with red bands on it, the receptionist recognised this as a sign that the patient was both visually and hearing impaired and she went to offer assistance. Following this training, adaptations had been made within the practice, such as installing high visibility toilet seats. In addition to the hearing loop in reception they also had a portable hearing loop and portable microphones for consultations. The font size used for patient letters was increased to make them easier to read for those with poor eyesight. Patients told us this was useful in maintaining confidentiality as they didn't have to ask other people to read the letter for them.

The practice offered a Chaplain service run by the local rector. This provided prompt access to a listening service that offered support or signposting, exploring the issues which were important to the patient. This was available to staff, patients and carers, irrespective of faith. It could be accessed by self referral or by referral from a member of staff. Patients told us this service was very easy to access and they felt more comfortable as the Chaplain service was less clinical than most services

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 April 2016

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

• The GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. They encouraged self management, particularly with patients who had a diagnosis of type two diabetes, by using the Year of Care Programme.

• Performance for diabetes indicators at 86% was 2% above the CCG average and 3% below the national average.

• 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.

Updated 15 April 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 or 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.

• In the last 12 months 69% of patients diagnosed with asthma had a review of their care which is comparable to local and national averages.

• Patients told us children and young people were treated in an age appropriate way and were recognised as individuals and we saw evidence on the day of the inspection to confirm this.

• Appointments for childhood immunisations could be made at any time, rather than a designated clinic.

• 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 and health visitors.

Updated 15 April 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 within 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 font used for letters to all patients had been enlarged to assist those with poor eyesight and we were told by patients on the day of the inspection that this simple change had been beneficial to them, maintaining confidentiality as they do not have to ask someone else to read the letter for them.

• Signs within the practice had been made easier to see and posters asking for patient feedback were also in a high visibility format with a large font.

• There were chairs available with arms on to assist those with limited mobility.

Updated 15 April 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.

• The practice offered extended hours from 7.30am to 8.00am on a Tuesday, Wednesday and Friday for working patients who could not attend during normal opening hours. The practice also offered lunchtime appointments at the request of the patients.

Updated 15 April 2016

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

• In the last 12 months 87% of patients diagnosed with dementia had their care reviewed in a face to face meeting. This is 10% higher than the CCG and national average.

• Performance in the mental health indicators are comparable with national averages.

• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients living with dementia.

• Patients experiencing poor mental health had been advised 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.

• All staff had received training in how to support patients living with dementia. On the day of the inspection we spoke with a carer of a person living with dementia. They told us that all the staff were understanding and supportive.

Updated 15 April 2016

The practice is rated as outstanding 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 worked closely with a home for people recently released from prison.

• All staff had received training in sensory awareness.

• Adaptations had been made throughout the practice for patients with sensory impairments.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multidisciplinary teams in the case management of people whose circumstances could make them vulnerable.

• People whose circumstances could make them vulnerable had been advised how to access various support groups and voluntary organisations, such as those for advice on substance misuse, housing or debt problems.

• Staff knew how to recognise signs of abuse in 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.

• The practice offered a GP chaplain service run by the local rector.