Archived: St. Luke's Surgery

Updated 31 January 2020

Dr Rifaat Amin (also known as St. Luke’s Surgery) is situated in the coastal town of Saltdean, East Sussex and is registered to provide services from:

Grand Ocean

Longridge Ave

Saltdean

BN2 8BU

All patient areas are accessible to patients with mobility issues. The local clinical commissioning group (CCG) is the NHS Brighton and Hove CCG. St Luke’s Surgery is registered with the Care Quality Commission to provide the following regulated activities:

• treatment of disease, disorder or injury

• diagnostic and screening procedures

• maternity and midwifery services

• surgical procedures

The practice provides services for approximately 2,100 patients living within the Saltdean and Rottingdean areas. The practice staff consists of one male GP, one female nurse, one female phlebotomist, a practice manager, secretary and three receptionists.

The practice has larger numbers of patients aged 65 and over compared to the national average. Deprivation amongst children and older people is low compared to the national average.

The practice is open between 8.30am and 6.00pm on weekdays and appointments are available from 8.30am to 11am and from 3.30pm to 5.30pm on Monday, Tuesday, Wednesday and Friday. On a Thursday afternoon, appointments are available from 4pm to 7pm as part of the practice’s extended hours service. When the practice is closed patients are given information on how to access the duty GP or the out of hour’s service (NHS111) by calling the practice or by referring to its website.

The practice shares its premises with another GP practice. Separate organisations providing services such as memory assessment clinics rent rooms in the same building.

More information in relation to the practice can be found on their website:

www.stlukessurgerysaltdean.nhs.uk

Updated 31 January 2020

We carried out an announced comprehensive inspection at St Luke’s on 26 November 2019 as part of our inspection programme.

We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:

• Safe
• Effective
• Caring
• Responsive
• Well-led

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as requires improvement overall and for safe, effective and well-led services. We rated them as good for caring and responsive services.

We have rated the practice as good for the population groups with the exception of working age people which is rated as requires improvement.

We found that:

• The practice did not always provide care in a way that kept patients safe and protected them from avoidable harm. Risks were not always managed effectively, as not all chaperones had received a DBS check or risk assessment relating to this and infection control records did not demonstrate effective practice.
• Patients did not always receive effective care and treatment that met their needs. Cervical screening rates were below target and clinical meetings were not held and there was insufficient supervision arrangements for nursing staff.
• There were ineffective governance systems in some areas, including the management of safety alerts and policies.
• Staff treated patients with care and compassion.
• Patients were positive about how they could access services in a timely manner.

The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The provider should:

• Make arrangements for nursing staff to complete safeguarding training at level three.
• Continue to work to improve the uptake of childhood immunisations.
• Work to improve the uptake of cervical screening.
• Maintain records of staff vaccination status in line with Public Health England guidance.
• Review areas where QOF exception reporting is higher than average.
• Review cholesterol monitoring and control.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 22 February 2017

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.

• Performance for diabetes related indicators was lower than the clinical commissioning group (CCG) and national averages. For example, patients with diabetes who had a blood pressure reading in the preceding 12 months of 140/80mmHg or less was 59% compared to the CCG average of 72% and the national average of 78%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP. 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 22 February 2017

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.
• 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 during 2015/2016 was 80%, which was similar to the clinical commissioning group (CCG) average of 80% and the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Baby changing facilities and a private room for breast feeding mothers were available.
• We saw positive examples of joint working with midwives and health visitors.

Updated 22 February 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 people in its population.

• As part of the ‘pro-active’ care initiative, the practice worked with other health and social care providers in the locality to identify patients at risk of avoidable, unplanned admission to hospital to ensure they had a care plan in place to prevent this.

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

Updated 22 February 2017

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.

• Phone consultations were available along with online appointment booking and prescription requests.

• 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 22 February 2017

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

• The practice results for the management of patients with poor mental health was comparable to the local and national averages. For example, 88% of their patients with severe and enduring mental health problems had a comprehensive care plan documented in their records within the last 12 months compared with the clinical commissioning group (CCG) average of 77% and the national average of 89%.

• The practice results for the management of patients diagnosed with dementia were lower than the CCG and national averages in 2015/2016. For example 64% of these patients had received a face-to-face review within the preceding 12 months compared to the CCG average of 77% and the national average of 84%.

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

• Patients at risk of dementia were referred to the memory assessment service.

• 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 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 22 February 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 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 other health care professionals, such as local pharmacies and care home 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.