Roundwell Medical Centre

Updated 31 March 2016

Roundwell Medical Centre is a large, purpose built practice situated in Costessey, Norwich. The practice provides services for approximately 12,113 patients. It holds a General Medical Services contract with South Norfolk CCG.

According to information taken from Public Health England, the patient population has a higher than average number of patients aged 0 – 4 and 25 – 34 years. It has a lower than average number of patients aged 49 – 85+ in comparison to the practice average across England.

The practice team consists of six GP partners, a salaried GP, a practice manager, two nurse practitioners, three practice nurses and two health care assistants. It also has teams of reception, administration and secretarial staff.

The practice is open from Monday to Friday. It offers appointments between 8am to 1pm and 2pm to 6pm. Extended hours clinics are also available between 6.30pm to 7.30pm on Monday evenings, and 7am to 8am on Tuesday mornings.

Roundwell Medical Centre was inspected in January 2014 using previous CQC methodology, and was found to be compliant with the legal requirements and regulations associated with the Health and Social Care Act 2008. The practice did not receive a rating following this inspection under CQC’s previous methodology.

Updated 31 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Roundwell Medical Centre on 2 February 2016. 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.
• Risks to patients were assessed and well managed.
• 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.
• Information about services and how to complain was accessible and easy to understand.
• 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.

The area where the provider should make an improvement is:

• Ensure that patient feedback continues to be monitored to identify areas for improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 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.
• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that performance for diabetes related indicators was 100%, which was above the CCG average by 8% and the England average by 11%.
• Longer appointments and home visits were available when needed.
• Patients with long-term conditions 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.
• The practice had a robust recall system for annual health and medication reviews.

Updated 31 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.
• 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’s uptake for the cervical screening programme was 81%, which was comparable to the CCG and England average. The practice also used the appointment as an opportunity to consult patients about their sexual health and contraception.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice had a private room available for breastfeeding.

Updated 31 March 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• An Age UK representative was available at the practice once a week for older patients to access help, information and signposting to relevant agencies.
• The practice offered health education leaflets for military veterans.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were above local and national averages.

Updated 31 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, flexible and offered continuity of care.
• Patients were able to get appointments between 6.30pm to 7.30pm on Monday evenings, and 7am to 8am on Tuesday mornings.
• 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.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years. The practice was able to refer patients to a health trainer to encourage lifestyle changes.
• The practice offered the meningitis B vaccination programme for university students.

Updated 31 March 2016

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

• 86% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan, which was 9.5% above the CCG average and 11.7% above the England average.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• An Admiral Nurse service was available for carers of patients with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations.
• The practice worked with the local Wellbeing Service, who held twice weekly clinics at the practice.
• 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 31 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, including 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 people.
• The practice held a weekly clinic run by the Norfolk Recovery Partnership for patients with drug or alcohol problems.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Patients who were carers were proactively identified and signposted to local carers’ groups.
• 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.