HavensHealth Also known as Meridian Surgery

Updated 1 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Starling and Partners on 19 February 2015. The practice was found to require improvement for providing safe services.

Following the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the regulations in relation to the following:

• Ensure that all staff are trained in safeguarding of vulnerable adults.
• Ensure staff have appropriate policies, procedures and guidance to carry out their role in relation to safeguarding vulnerable adults.
• Ensure criminal records checks are undertaken via the Disclosure and Barring Service for staff trained to provide chaperone services or that risk assessment is undertaken to establish the reason why those staff should not be subject to a criminal records check.

Our previous report also highlighted areas where the practice should improve:

• Include advocacy and ombudsman details in information given to patients about how to make a complaint.

We undertook this focused inspection on 19 August 2015 to check that the provider had followed their action plan and to confirm that they now met the regulations. At this inspection we found the practice was good for providing safe services.

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

• All staff had received training in the safeguarding of vulnerable adults.
• The practice had developed appropriate policies and guidance to support staff in the safeguarding of vulnerable adults.
• The practice had undertaken criminal records checks via the Disclosure and Barring Service for all staff trained to provide chaperone services.
• Advocacy and ombudsman details were provided to patients to support them in the making a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 June 2015

The practice is rated as good for the care of patients 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. Care plans had been introduced to minimise the risk of unplanned hospital admissions. Longer appointments and home visits were available when needed. All of these patients had a named GP and a structured annual review to check that their health and medication 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 25 June 2015

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. Practice staff had received training in the safeguarding of children relevant to their role. Staff were aware of child safeguarding procedures and how to respond if they suspected abuse. 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. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 25 June 2015

The practice is rated as good for the care of older patients. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs. All patients over the age of 75 years had a named GP. The practice ensured early referral to services for memory assessment.

Updated 25 June 2015

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 offered extended hours by opening late on one evening each week and on some Saturday mornings, to meet the needs of patients who worked during the day. 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. Health checks were available to all new patients registering with the practice. NHS health checks were available to all patients aged from 45-74 years. The practice participated in the C card scheme which enabled card carriers under the age of 25 years to access free of charge contraception and relevant advice. Staff within the practice had recently received updated training in providing sexual health and contraceptive services. The practice ran a sexual health clinic one evening per week. This included a drop-in service for any young person, regardless of the practice where they were registered, as well as a comprehensive range of contraceptive services and sexual health screening and treatment. The practice had developed links with a local community college and provided regular talks to young people about sexual health.

Updated 25 June 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. GPs in the practice worked closely with the community mental health team to refer patients for counselling or cognitive behavioural therapy via the Health in Mind programme. The practice had identified a lead GP for the management of patients with poor mental health. It carried out care planning for patients with poor mental health such as dementia and learning disabilities. The practice undertook dementia screening of patients and ensured early referral to memory assessment services. The practice provided information to patients experiencing poor mental health about how to access various support groups and voluntary organisations. Longer appointments were available to patients if required.

Updated 25 June 2015

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 those with a learning disability. It had carried out annual health checks for patients with a learning disability. Longer appointments were available to patients where needed, for example when a carer was required to attend with a patient. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had identified those vulnerable patients requiring support to minimise the risk of accident and emergency attendance and unplanned hospital admissions. Care planning was in place to support those patients. Patients receiving palliative care were supported by regular multidisciplinary team reviews of their care needs. 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.