Archived: The Surgery - Foden Street

Updated 28 January 2016

The Surgery – Foden Street is registered with the Care Quality Commission (CQC) as a partnership provider.

The locality has a higher level of deprivation when compared with the national average. The practice has a higher number of patients with a long-term health condition with 62.2% of patients in this category; the national average is 54%.

The practice is open from 8am to 6pm on Monday, Tuesday, Wednesday and Friday and from 8am to 1pm on a Thursday. During these times the reception desk and telephone lines were always staffed. Patients could book appointments in person and by telephone

The practice clinical team consists of two GPs (one male, one female) both work full time hours, two practice nurses (WTE 1.03) are employed, although one has been on long-term leave for a number of months. The practice administrative and reception team is overseen by the practice manager, assistant practice manager and contains seven administrators or receptionists. A care co-ordinator is employed by the practice on a part time basis to proactively review the care provided to patients over 65 and those who have attended accident and emergency.

The practice has opted out of providing cover to patients in the out-of-hours period. During this time services are provided by Staffordshire Doctors Urgent Care, patients access this service by calling NHS 111.

Updated 28 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Surgery – Foden Street on 23 November 2015. Overall the practice is rated as requires improvement

Our key findings were as follows:

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.

• The practice did not undertake all of the necessary checks required when recruiting staff.

• Staff assessed the risks of infection control, although had not always acted on the risks identified.

• The practice had a number of policies and procedures to govern activity, but some were overdue a review.

The areas where the provider must make improvements are:

• Ensure recruitment checks for staff meet legislative requirements.
• Implement a consistent and effective system to receive and act on medicines alerts.
• Mitigate the risks identified in infection prevention and control audits.
• Implement a system to detail and record the checks undertaken on emergency equipment.
• Ensure that accurate records are kept of staff members’ suitability for employment and have oversight of the training they have undertaken.
• Provide all staff with appraisals.
• Review the policies and procedures in use, to ensure they are up to date and reflect the environment in which they operate.

In addition the provider should:

• Follow a consistent method of recording the stages of reporting, investigating and learning from significant events.

• Provide all staff with training in safeguarding vulnerable adults

• Review the computerised records of children identified at increased risk of harm to ensure they contain relevant and up to date information about safeguarding concerns.

• Consider the implementation of guidance issued by Public Health England on the storage of vaccines. In particular consideration of ensuring power to the vaccine fridge is not accidentally interrupted.

• Improve storage and handling of blank prescription forms to reflect nationally accepted guidance as detailed in NHS Protect Security of prescription forms guidance.

• Ensure that patients, visitors and staff are protected from the risk of water borne infection by means of completing a legionella risk assessment.

• Improve the availability of emergency medicine to include medicines to treat prolonged convulsions (fitting).

• Promote the availability of national cancer screening programmes.

• Improve the availability of appointments with a practice nurse.

• Consider the introduction of online booking of appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for the diabetes related indicators was better than the CCG and national averages. For example, 79% of patients with diabetes had received a recent blood test to indicate their longer term diabetic control was below the highest accepted level, compared with the CCG average of 75.1% and national average of 77.5%.

• 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 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• 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 76.1% which was lower than the CCG average of 79.9% and the national average of 81.8%.

• 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.

Updated 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• 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, and offered home visits and urgent appointments for those with enhanced needs.

Updated 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• 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 a full range of health promotion and screening that reflects the needs for this age group.
• Patients could order repeat prescriptions online, although they could not book appointments online.

Updated 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• 83.3% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

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

Updated 28 January 2016

The practice was rated as good for effective, caring and responsive services overall and this includes for this population group. The practice was rated as requires improvement for safety and for well-led services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

• The practice kept a register of patients with a learning disability and had performed a recent audit in providing reviews for these patients.

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

• Clinical 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.