Fairfield Park Health Centre

Updated 31 October 2016

Letter from the Chief Inspector of General Practice

In February 2016, a comprehensive inspection of Dr Bevan & Partners was conducted. The practice was rated as requires improvement for safe and good for effective, caring, responsive and well led. Overall the practice was rated as good.

We found that the practice required improvement for the provision of safe services because improvements were needed in the way the practice assessed, managed and mitigated the risk associated with the spread of infections and with fire safety.

Dr Bevan and Partners sent us an action plan which set out the changes they would make to improve in these areas.

We carried out an announced desk top inspection of Dr Bevan & Partners on 20 September 2016 to ensure the practice had made these changes and that the service was meeting regulations. At this inspection we rated the practice as good for providing safe services. The overall rating for the practice remains good. For this reason we have only rated the location for the key question to which this related. This report should be read in conjunction with the full inspection report published on 16 February 2016.

Our key findings were:

• The practice had processes in place to prevent, detect and control the spread of infections, including those that are health care associated.
• Comprehensive fire risk policies and procedures were in place.
• Recommended training had been undertaken by practice staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 April 2016

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.
• Patients with more than one chronic disease were able to book a longer appointment so that visits to the practice were minimised for the patient.
• A nurse visited housebound older patients at home and carried out annual reviews where appropriate.
• The percentage of patients on the diabetes register, with a record of a footexamination and risk classification within the preceding 12 months (04/2014 to 03/2015) was 88% which was the same as 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 18 April 2016

The practice is rated as good for the care of families, children and young patients.

• 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 patients 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 patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years was 85% compared to a national average of 82%.

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

Updated 18 April 2016

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

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

• The practice was responsive to the needs of older patients, and offered longer appointments, home visits and urgent appointments for those with enhanced needs.

• A named GP was responsible for the care of older patients in a nursing home and conducted weekly visits.

• Care plans were in place for 324 patients that the practice had identified as being at risk of hospital admissions. One hundred and ninety nine of these were for patients over the age of 75 years.

Updated 18 April 2016

The practice is rated as good for the care of working-age patients (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.

• Commuter clinics were available for both GPs and nurses on a Saturday morning.

• The age profile of patients at the practice was mainly those of working age, students and the recently retired. 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.

• The practice provided extensive online health promotion, advice and support which were tailored to meet the needs of its student population.

Updated 18 April 2016

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in

  the record, in the preceding 12 months was 91% compared to a national average of 88%.

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

• 74% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is lower than the CCG average of 86% and the national average of 84%.

• The practice 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.

• The practice hosted a counsellor on site to provide care for patients who required mental health support.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 18 April 2016

The practice is rated as good for the care of patients 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 offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• The practice informed 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.