Far Lane Medical Centre

Updated 12 June 2017

Far Lane Medical Centre and the branch site known as Trafalgar House Medical Centre is located in Hillsborough, Sheffield and accepts patients from the surrounding area. The practice catchment area has been identified as one of the fifth most deprived areas nationally.

The practice provides General Medical Services (GMS) under a contract with NHS England for 7443 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery and childhood vaccination and immunisations.

Far Lane Medical Centre has three male GP partners, a salaried female GP, three female practice nurses, practice manager, finance manager and an experienced team of reception and administration staff.

The main site and the branch site are open 8am to 6pm Monday to Friday with the exception of Thursdays when the practice closes at 12 noon. The GP collaborative provides cover when the practice is closed on a Thursday afternoon. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursdays when there are no afternoon appointments. The practice does not provide extended hours.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 6pm and 6.30pm. Patients are informed of this when they telephone the practice number.

The practice was previously inspected by the Care Quality Commission (CQC) on 10 March 2016 and rated good with requires improvement in safe. Enforcement action was taken and requirement notices issued with regard to Regulation 12 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. The link to this report can be found by selecting the ‘all reports’ link for Far Lane Medical Centre on our website at www.cqc.org.uk. A focused follow up inspection was programmed on 20 February 2017 to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was meeting legal requirements. The requirement notices had not been met so we scheduled a comprehensive inspection for 26 April 2017.

The practice carry out regulated activities at the main site, Far Lane Medical Centre and at the branch site known as Trafalgar House:

Far Lane Medical Centre, 1 Far Lane, Sheffield S6 4FA

Trafalgar House Medical Centre, 4 Halifax Road, Sheffield S6 1LA

Trafalgar House was visited as part of the inspection in March 2016. During this inspection we spoke with staff who worked at the branch site but did not visit it as part of this inspection.

Updated 12 June 2017

Letter from the Chief Inspector of General Practice

This practice was previously inspected by the Care Quality Commission (CQC) in March 2016 and rated good with requires improvement for safe. Enforcement action was taken and requirement notices issued with regard to Regulation 12 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. The link to this report can be found by selecting the ‘all reports’ link for Far Lane Medical Centre on our website at www.cqc.org.uk. A focused follow up inspection was programmed on 20 February 2017 to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was meeting legal requirements. The requirement notices had not been met so we scheduled a comprehensive inspection.

We carried out an announced comprehensive inspection at Far Lane Medical Centre on 26 April 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had systems in place to minimise risks to patient safety.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However, there was limited evidence of reported incidents and lessons learned were not communicated widely enough to support improvement.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. There were some shortfalls with regard to chaperone training of staff who worked at the branch site and infection control training.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients we spoke with said they found it difficult to access the practice by telephone to make an appointment though access to urgent appointments the same day were available when required.
• 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 sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure staff who perform chaperone duties at the branch site are trained for the role.

• Encourage staff to report significant events and ensure lessons learned are communicated widely enough to support improvement.

• Review the system for monitoring of cleaning schedules.

• Review ways to identify carer’s and add them to the carer’s register to be able to offer them support.

• Consider patient feedback regarding telephone access and implement the action plan for improvement as soon as practicable.

• Monitor the system implemented to improve security and track blank prescription forms.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 12 June 2017

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

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

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• All these patients had a named GP and there was a system to recall patients for 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 12 June 2017

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

• There was a system 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 accident and emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

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

• The practice worked with midwives and health visitors to support this population group.

• The practice had emergency processes for acutely ill children and young people.

• The practice is Lo-down accredited, which means it aims to support all young people to improve their health and well-being. This is promoted to patients on the practice website. The practice welcomes young people to come and talk to staff about any health-related issues they may have, including all aspects of sexual health, smoking, drug, alcohol issues and healthy eating advice.

Updated 12 June 2017

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 patients in its population.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

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

Updated 12 June 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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 offered online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 12 June 2017

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

• The practice carried out advance care planning for patients living with dementia.

• Of those patients diagnosed with dementia 92% had had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 85% and national average of 84%.

• Of those patients diagnosed with a mental health condition, 93% had a comprehensive care plan reviewed in the last 12 months, which is above the CCG average of 90% and national average of 89%.

• The practice specifically considered the physical health needs of patients with poor mental health and those living with dementia at their annual review appointment.

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

• Patients at risk of dementia were identified and offered an assessment.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

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

Updated 12 June 2017

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.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff we spoke with knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.