Archived: Quinton Family Practice

Updated 10 March 2016

Quinton Family Practice is one of three locations registered with CQC under the provider Lordswood House Group Medical Practice. Collectively the practices have approximately 25,000 patients. Quinton Family Practice has approximately 3,300 of these patients registered at their location. Data available and included in this report relates to all three practices.

The staffing, policies, systems and procedures are centrally managed and are reflective across all three registered practices. We inspected the main site Lordswood House Group Medical Practice on the 11 September 2015 and have inspected both remaining sites Quinborne Medical Practice and Quinton Family practice on the 20 November 2015. All three practices are registered individually with CQC, and therefore each site has an individual report and rating. However, as the provider has one General Medical Services (GMS) contract, patient list and clinical data system the data included in this report reflects all three practices.

The practice 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. The practice has a 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 merged with a larger partnership in 2008 and the premises were redeveloped in 2011. 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:

• Monday 8.30am – 6.00pm
• Tuesday 8.30am – 6.00pm
• Wednesday 8.30am – 6 00pm
• Thursday 7.30am – 1.00pm and 5.30pm - 7.30pm
• Friday 8.30am – 6.00pm

Appointments are available Monday and Friday 8.30am – 11.20am and 3.50pm – 5.40pm, Tuesday and Wednesday 9.00am – 11.40am and 4.30pm – 6.00pm, Thursday 7.30am – 10.50am and 5.30pm – 7.15pm.

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 two GPs (male and female). Other practice staff consist of a practice nurse, practice manager and a team of administrative staff. Staff from the other locations provide cover for nursing and administrative functions when required.

The practice has not previously been inspected by CQC.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Quinton Family Practice part of the Lordswood House Group on 20 November 2015. Overall the practice is rated as good. Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored and appropriately reviewed and addressed.
• There were systems in place to manage risks to patients who used the services but these were not well implemented in all areas. For example, evidence of equipment checks.
• Patients’ needs were addressed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients were positive about the care and treatment they received. They said they were treated with dignity and respect and were involved in their care and decisions about their treatment.
• Information about how to complain was available and easy to understand.
• Patients were satisfied that they were able to obtain 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 senior staff and partners at the practice. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvements:

• Ensure risks have been assessed and implement any actions in relation to the safe and secure management of records.
• Maintain accurate records to ensure checks of emergency equipment have been completed.
• Ensure all staff receive feedback from meetings, when they are unable to attend.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2016

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

• Patients with long term condition had a named GP responsible for the co-ordination and management of their care needs.
• The practice worked with other health and care professionals to plan to deliver a multidisciplinary package of care for those with the most complex needs.
• Clinical staff had lead roles in chronic disease management to provide appropriate support and were appropriately trained for these roles.
• Nationally reported data showed that the outcomes for patients with long term conditions were consistently better than other practices in the CCG and nationally. For example, QOF points received for the management of patients with conditions such as diabetes, asthma and heart failure were all higher than the CCG and national averages.
• Performance for diabetes related indicators was at 97% which was higher than both the CCG average and national average of 89%.
• Longer appointments and home visits were available for those who needed them.

Updated 10 March 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 or failed to attend for immunisations.
• Uptake of childhood immunisation rates comparable to the national average and flexible approach was used to ensure children received their vaccinations.
• There was evidence of effective joint working with midwives and health visitors.
• Paediatric out patients services were hosted at Lordswood House Group Medical Practice which is the main practice site for the convenience of patients.
• Uptake of cervical screening was comparable to CCG and national averages.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 10 March 2016

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

• Patients received personalised care from a named GP to support continuity of care.
• The practice was responsive to the needs of older people offering home visits and urgent appointments for those who needed them.
• Named GP for the management of patients in older age group.
• The premises were accessible to patients with mobility difficulties.
• Secondary care services such as audiology and ophthalmology were available locally to patients at the provider’s main practice for the convenience of patients.
• Nationally reported data showed that the outcomes for patients with conditions commonly found in older people were consistently better than other practices in the CCG area and nationally.
• The percentage of people aged 65 or over who received a seasonal flu vaccination was comparable to the national average.
• Shingles vaccinations were also available for eligible patients.
• 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.
• Patient record systems were compatible with the hospice so that patient information could be shared real time supporting timely care and treatment.

Updated 10 March 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 and flexible. For example extended opening and online services for the convenience of patients who worked or had other commitments during the day.
• A range of health promotion and screening was available including NHS health checks, smoking cessation and travel advice and vaccinations.
• Use of text reminders for appointments.
• Sexual Health and contraceptive services.

Updated 10 March 2016

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 documented care plans that had been agreed with the individual, their family and/or carers as appropriate.
• Patients had access to counselling services and could also self-refer to the Improving Access to Psychological Therapies (IAPT) who provides support to those with common mental health conditions such as anxiety and depression.
• The provider had increased the register for patients with dementia between April 2014 and March 2015 from 93 to 116. This showed that they were actively identifying patients in order to ensure they received appropriate support at the earliest opportunity.
• The practice had obtained support from a ‘dementia friend’ to help educate staff in relation to dementia.
• Although no formal meetings took place the practice described good working relationships with the community mental health team through regular telephone contact.

Updated 10 March 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 for example those with a learning disability and carers enabling additional support to be provided.
• The provider was in the process of training staff to provide comprehensive health checks for those with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people to support their care needs.
• Patients were referred to and signposted to access various support groups and voluntary organisations, For example, counselling services and substance misuse services hosted at Lordswood House which is the practices main site.
• 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.