Archived: Dr Larissa Tate Also known as The Haven Practice

Updated 14 January 2016

Dr Larissa Tate offers general medical services to people living and working in Brighton and Hove. It is a practice with two GP partners (male and female). There are three practice nurses, a healthcare assistant, practice and business managers and a team of administrative staff. There are approximately 3050 registered patients.

The practice runs a number of services for its patients including asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, travel advice and weight management support.

Services are provided from:

The Haven Practice

100 Beaconsfield Villas

Brighton

East Sussex

BN1 6HE

The practice has opted out of providing Out of Hours services to their patients. There are arrangements for patients to access care from an Out of Hours provider (111 ).

The practice population has a higher than average number of patients aged 0 to 4 years and a lower than average number of patients over the age of 65. The practice has a lower deprivation score compared to the national average, with more patients in employment or full-time education and lower levels of unemployment.

Updated 14 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Larissa Tate (The Haven Practice) on 16 September 2015. 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.
• 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 said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice achieved higher than average scores in many areas of the national GP patient survey.
• Information about services and how to complain was available and easy to understand.
• Patients said 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 provider was aware of and complied with the requirements of the Duty of Candour.
• Risks to patients were generally assessed and well managed with the exception of the management of vaccines stored in a fridge that had recorded temperatures outside of the suitable range for storage and a risk assessment that had not been completed for the decision not to have a defibrillator on the premises.
• The practice was registered with CQC (Care Quality Commission) as an individual provider. However, we found that the service was operating as a partnership and had not amended their registration accordingly.

The areas where the provider must make improvements are:

• Ensure that action is taken to ensure the cold chain is maintained for vaccines stored in the vaccines fridge.
• Ensure that a risk assessment is recorded with mitigating actions for the decision not to have a defibrillator on the premises.
• Ensure that the process for assessing risk within the practice incorporates the assessment of all environmental and situational risks and that actions to reduce risk are clear and recorded.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 January 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 and recorded on the practice unplanned admissions register.

• The practice had an effective system for recalling patients with long-term conditions for regular reviews and to identify those not attending for review within a certain period of time.

• The practice performed above national and CCG averages for diabetes care (QOF data).

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines 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.

Updated 14 January 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 was above national (2.2%) and CCG (6.5%) averages in relation to uptake of cervical screening.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 14 January 2016

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

• The practice had a low proportion of older patients, less than 7% of the total number of patients registered.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• It was responsive to the needs of older people, identified housebound patients and offered home visits and urgent appointments for those with enhanced needs.

Updated 14 January 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. For example, they offered a weekly extended hours nursing appointment for patients in this group.

• 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 14 January 2016

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

• 82% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months; this was higher than the CCG (8.2%) and national (4.8%) averages.

• 91% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented; this was higher than the CCG (23.2%) and national (13.7%) averages.

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

• It 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.

• It 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 people with mental health needs and dementia.

Updated 14 January 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.

• Patients living in vulnerable circumstances had individual care plans developed in line with the practice’s unplanned admissions register.

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

• The practice regularly worked with multi-disciplinary 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.