Forest House Medical Centre

Updated 28 December 2016

Forest House Medical Centre is a seven partner practice which provides primary care services to approximately 14000 under a General Medical Services (GMS) contract.

• The practice is situated across two sites in Leicester Forest East. Both sites have car parking with disabled spaces.

• Forest House Medical Centre has a car park with a disabled bay and on street parking nearby.

• Warren Lane Surgery is a purpose built surgery situated within a popular housing estate. There is a designated car park with disabled parking bays and further street parking is available if required.

• Services are provided from 2a Park Drive, Leicester Forest East, Leicester, Leicestershire, LE3 3FN and Warren Lane, Leicester Forest East, Leicester, Leicestershire, LE3 3LW.

• The practice consists of seven partners (four male and three female).

• The nursing team consists of two nurse practitioners, two practice nurses, two health care assistants (HCA) and two phlebotomists.

• The practice has a practice manager who is supported by 20 clerical and administrative staff to support the day to day running of the practice.

• When the practice is closed patients are able to use the NHS 111 out of hours service.

• The practice has a lower than average number of patients aged 0 to 39 years of age and higher than average number of patients 50 years of age and above.

• 1.5% of the patients are in residential care homes.

• The practice provides training for doctors who wish to become GPs and at the time of the inspection had two doctors undertaking training at the practice. (Teaching practices take medical students and training practices have GP trainees and F2 doctors).

• The practice has low deprivation and sits in the second least deprived centile.

• The practice is registered to provide the following regulated activities; surgical procedures; family planning, diagnostic and screening procedures, maternity and midwifery services; and treatment of disease, disorder or injury.

• The practice lies within the NHS East Leicestershire and Rutland Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

• The practice is open between 8am and 6pm Monday to Friday. Forest House Medical Centre has pre bookable nurse appointments available Saturdays 8.30am to 12pm.

Updated 28 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Forest House Medical Centre on 15 November 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patient survey figures showed patients rated the practice lower than others for some aspects of care. The practice had an action plan to improve on the areas highlighted.
• Comments about the practice and staff were positive, however some patient said they found it difficult to make an appointment others stated that they had no problems.
• 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 available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs although the staff commented that the practice at Forest Medical Centre was in need of decoration.
• 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.
• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons.

• There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular meetings.

• The practice had a high number of patients in residential care homes, approximately 1.5% of their patients.

• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

• The practice had identified 140 patients as carers (1% of the practice list).

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.
• Complete any actions from Legionella risk assessment as required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 December 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.

• Nurse appointments were available Saturday mornings.

• Performance for diabetes related indicators was comparable to CCG and national averages. (91% compared to 93% CCG average and 90% national average).
• Longer appointments and home visits were available when needed.
• The practice worked with community specialist nurses for heart failure, complex diabetic patients and chronic obstructive pulmonary disease patients.

Updated 28 December 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 above CCG averages 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 80%, which was similar to the CCG average of 79% and the national average of 76%.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 28 December 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 provided medical care to six local care homes and weekly ward rounds with a lead GP designated to one of the homes.

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

• Reviews were completed in patients home were required.

• The practice worked with the multi-disciplinary teams in the care of older vulnerable patients.

Updated 28 December 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 and flexible.

• Appointments were available on the day and there was an option to book an appointment with a GP for the next day.

• Saturday morning nurse clinics were available.

• Patients could book appointments on line and patients were sent a text message to remind them of their appointment.

• 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 28 December 2016

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

• 71% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was below the CCG average of 81% and the national average of 84%.

This meant that the practice needed to complete 140 face to face reviews due to the higher number of patients that were diagnosed with dementia. This was part of the work that the supporting vulnerable practice scheme was working toward so that by adapting some processes and working more efficiently would give the practice more time to focus on areas of need such as this.

• 90% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the 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.

• 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.

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

Updated 28 December 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 register was monitored to ensure patients were attending for their annual reviews.

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

• The practice arranged home visits for those patients in residential care when required and to complete annual reviews.

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

• 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.