Background to this inspection
Updated
22 August 2016
Lordswood House Group is part of the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.
Lordswood House Group is registered with the Care Quality Commission to provide primary medical services. It is one of three practice locations registered with CQC under the provider Lordswood House Group Medical Practice. The other two being Quinton Family Practice and Quinborne Medical Practice. Collectively the practices have approximately 25,000 patients, approximately 16,000 were registered with this practice. The three registered locations operate under a single general medical service (GMS) contract with NHS England. Under the GMS contract the practice is required to provide essential services to patients who are ill and includes chronic disease management and end of life care.
The practice is located in a purpose built health centre which it shares with another community health services. Based on data available from Public Health England, deprivation in the area served by the three practices is slightly higher than the national average.
The practice is open for appointments on:
Monday 8.30am – 7pm
Tuesday 7.30am – 6.30pm
Wednesday 7.30am – 6pm
Thursday 7.30am – 7pm
Friday 7.30am – 6.30pm
The practice’s extended opening hours are between 7.30am and 8am Tuesday to Friday, 6.30pm to 7pm on Monday and Thursday and Saturday mornings 8am to 11am.
When the practice is closed during the out of hours period (6.30pm to 8am) patients receive primary medical services through an out of hours provider (BADGER).
The practice has ten GP partners (both male and female) and three salaried GPs. Other practice staff consist of a team of six nurses and three healthcare assistants, a practice manager and a team of administrative staff. Some of the administrative functions are shared with the provider’s other locations. The practice is also a training practice for doctors who were training to be qualified as GPs and a teaching practice for medical students.
Updated
22 August 2016
Letter from the Chief Inspector of General Practice
We carried out focussed inspection at Lordswood House Group on 29 June 2016. The practice had previously been inspected in September 2015 and was rated as requires improvement for providing safe services. The practice was found to be in breach of regulation 19 and schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Recruitment records seen did not demonstrate that appropriate checks had been undertaken to ensure fit and proper persons were employed at the practice. Following the inspection the practice sent us an action plan detailing the action they were going to take to improve.
We returned to the practice to consider whether improvements had been made in response to the breach in regulations. We found the practice had made improvements and is now rated as good for providing safe services. This report should be read in conjunction with our previous inspection report for the practice.
Our findings were as follows:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
12 November 2015
The practice is rated as good for the care of people with long-term conditions. Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Home visits were available if needed. All these patients had a named GP who co-ordinated the management of their condition. Patients received structured annual reviews to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Staff received additional training to help them support patients with long term conditions such as diabetes.
Families, children and young people
Updated
12 November 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. There was evidence of joint working with health visitors and midwives in the provision of care. Immunisation rates were relatively high for all standard childhood immunisations. Various services including baby checks and antenatal checks were available. Paediatric clinics were also available onsite run by the local children’s hospital. Children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and same day appointments for sick children. The premises were suitable for children and babies.
Updated
12 November 2015
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. Patients had access to a named GP for the continuity of care. Those at high risk of hospital admission and end of life care needs were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care. The practice carried out weekly ward rounds at a local care home and we received positive feedback from the home about this. It was responsive to the needs of older people, and offered home visits. Onsite services were available such as anti-coagulation, musculoskeletal and audiology to reduce the need for patients to travel to hospital.
Working age people (including those recently retired and students)
Updated
12 November 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 was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.
People experiencing poor mental health (including people with dementia)
Updated
12 November 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of patients experiencing poor mental health and the majority of these patients had received an annual physical health check. Patients had access to on-site counselling services and could also self-refer to the Improving Access to Psychological Therapies (IAPT) who provide support to those with common mental health conditions such as anxiety and depression. The practice had a register for those with dementia, and care plans were in place for the majority of these patients. The practice had obtained support from a ‘dementia friend’ to help educate staff in relation to dementia.
People whose circumstances may make them vulnerable
Updated
12 November 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 some annual health checks on patients with a learning disability and all had received a ‘passport’ which recorded important information about their needs, likes and dislikes. The practice also held a carers register which enabled them to target specific services. Those with drug or alcohol dependency had access to a drugs worker on site as part of a shared care programme. HIV testing was also available to patients at one of the providers other locations.
The practice regularly worked with multidisciplinary teams in the case management of vulnerable people. It had told 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.