Rectory Meadow Surgery

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

In April 2015 we found concerns related to the recruitment of staff during a comprehensive inspection of Rectory Meadow Surgery. Following the inspection the provider sent us an action plan detailing how they would improve recruitment and undertake necessary staff checks. We carried out a desktop review of Rectory Meadow Surgery on 4 December 2015 to ensure these changes had been implemented and that the service was meeting regulations. Our previous inspection in April 2015 had found a breach of regulations relating to the safe delivery of services. The ratings for the practice have been updated to reflect our findings.

We found the practice had made improvements since our last inspection on 29 April 2015 and they were meeting the regulation relating to the recruitment of staff that had previously been breached. The practice had also taken full heed of our report with regards to accurate information, training and subsequent action to take in the event of needle stick injury.

Specifically the practice was:

• Operating safe systems in relation to the recruitment of staff.

• Providing up-to-date information and training for needle stick injuries which was supported by a revised needle stick injury procedure.

We have changed the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 18 June 2015

The practice is rated as good for the care of people with long term conditions. Chronic disease management was well managed within the practice, and this was reflected in national data and tools used to plan patients treatment and care. Plans for patients at risk of unplanned admissions to hospital were written to reduce the risk of this occurrence. Longer appointments and home visits were available when needed. There were lead GPs and nurses for managing specific conditions such as diabetes and respiratory diseases. This enabled staff to provide expertise in caring for these conditions. Nurses received training to provide reviews of patients health needs. The practice endeavoured to ensure patients saw only their named GP to maximise the continuity in their care.

Updated 18 June 2015

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, and systems to ensure staff were aware when seeing children who were at risk of harm or abuse. Immunisation rates were close to average for most standard childhood immunisations. The premises were easily accessible for patients attending with prams and buggies. Sexual health advice and services were available to patients. Pre and post-natal clinics were provided.

Updated 18 June 2015

The practice is rated as good for the care of older people. The practice had the highest number of over 75s in the locality at 15%. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. End of life care was well managed and this included high numbers of patients with a preference to die at home having this wish respected (93% of patients died at home in 2014/15). End of life care included external professionals in planning and implementation. The practice was responsive to the needs of older people; they offered home visits, regular reviews of care for patients in a local care home and rapid access appointments for those with enhanced needs. Patients in care homes had an allocated GP. The premises were easily accessible for patients with limited mobility. Plans for patients at risk of unplanned admissions to hospital were written to reduce the risk of this occurrence. The practice had improved its diagnosis rate for dementia significantly within the last year.

Updated 18 June 2015

The practice is rated as good for the care of working age people (including those recently retired and students). Online appointment booking was available. There were extended hours appointments on Monday nights. Feedback regarding the appointment system was very positive from patients. Travel clinics were available. The practice provided a full range of health promotion and screening that reflected the needs of this age group. New patient health checks were offered.

Updated 18 June 2015

The practice is rated as good for the care of those experiencing poor mental health. Patients experiencing poor mental health were offered an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia and early screening for the disease. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Counselling was available to patients on-site.

Updated 18 June 2015

The practice is rated good for the care of patients whose circumstances make them vulnerable. The practice had carried out checks for patients with a learning disability and offered these patients longer appointment slots. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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. The practice worked with patients in local supported living accommodation and provided them with named GPs, health advice and care planning. Staff confirmed that any patients who did not have an address to provide to the practice, would still be seen by an appropriate clinician.