Dr Ian Allsebrook Also known as The Harrowby Lane Surgery

Updated 5 May 2016

Dr Allsebrook also known as The Harrowby Lane Surgery provides primary medical services to approximately 5,346 patients in Grantham, South West Lincolnshire. The practice also provides services to patients residing in eight residential care and nursing homes in the surrounding area.

Dr Allsebrook’s practice is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning, maternity and midwifery services and surgical procedures.

At the time of our inspection the practice employed one GP partner and one salaried GP, an advanced nurse practitioner, a nurse practitioner, a practice nurse and two health care assistants. They are supported by a practice manager, assistant practice manager, a secretary and four reception staff. The surgery is open from 8am to 6.30pm Monday to Friday. An ‘open surgery’ is provided from 8am until 10.30am Monday to Friday for routine, on the day appointments.

The practice has a Personal Medical Services (PMS) contract. The PMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The practice has a higher distribution of patients between the ages of 15 and 64 years of age.

The surgery is purpose built in 2003, spacious, and is of two storey construction, providing good access to patients and carers. A separate waiting area on the first floor is provided for patients who are visiting the nursing staff. Sufficient car parking is available and some bays close to the entrance doors are designated for the use of patients with restricted mobility. The premises has adequate disabled facilities and a lift.

The practice has one location registered with the Care Quality Commission (CQC) which is Dr Ian Allsebrook (also known as The Harrowby Lane Surgery), Harrowby Lane, Grantham, Lincolnshire, NG31 9NS.

The practice operates an advanced access appointment system which enables patients to book a routine appointment up to eight weeks in advance. In addition to pre-bookable appointments that can be booked in advance, urgent appointments are also available for people that need them. The practice offers on-line services for patients such as on-line appointment booking, ordering repeat prescriptions and viewing patient summary care record.

The practice has an active patient participation group (PPG) who meet every two months, the practice also has a virtual PPG who communicate by email.

Updated 5 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ian Allsebrook practice on 14 January 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. There was a risk register in place with various health and safety risk assessments carried out and reviewed on a regular basis.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• 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.

• The practice employed a care coordinator to deliver care plans for older patients and those who were vulnerable.

• All patients diagnosed with dementia had a care plan in place which was reviewed on a regular basis.

• 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. The practice offered an open access clinic for on the day, routine appointments on a daily basis.

• 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 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 May 2016

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

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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 multi-disciplinary package of care.

• The practice held regular palliative care meetings to review patient’s needs.

• The GPs provided regular clinical support to patients who resided in a local hospice.

• The practice participated in an admissions avoidance scheme and delivered personalised care plans and regular reviews for patients with a long term condition with a view to deliver more personalised care and to reduce emergency or unplanned hospital admissions.

Updated 5 May 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 relatively high for all standard childhood immunisations.

• The practice provided childhood immunisation clinics.

• The practice’s uptake for the cervical screening programme was 80.2% which was comparable to the CCG average of 80.9%.

• 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.

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

• We saw positive examples of joint working and the practice held regular meetings with midwives, health visitors and school nurses.

• The practice provided weekly midwifery led clinics.

• The practice provided smoking cessation advice clinics.

Updated 5 May 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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice employed a care coordinator to give additional support and ensured care plans were implemented and reviewed on a regular basis for older people. The care coordinator also visited patients who resided in care and nursing homes to review care plans.

• All housebound patients had a care plan in place which was reviewed on a regular basis.

• At the time of our inspection the practice were working towards the achievement of a carer’s award.

Updated 5 May 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, flexible and offered continuity of care.

• The practice was proactive in offering online services such as ordering repeat prescriptions appointment booking and viewing patient summary care records as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice participated in an electronic prescribing service.

• The practice offered a text reminder service for booked appointments.

• The practice offered telephone consultations for patients who were unable to attend for an appointment.

Updated 5 May 2016

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

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

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

• The practice was a member of a local group ‘Dementia Action Alliance’ who promoted identification of dementia within the local area and attended regular meetings with this group.

• The practice ensured care plans were in place for all patients who suffered poor mental health.

• The practice worked closely with local mental health teams with a view to providing in-house clinics for patients suffering poor mental health in familiar surroundings.

• The practice participated in a South West Lincolnshire Clinical Commissioning Group (SWLCCG) ‘dementia diagnosis care home project’ and employed a care coordinator to visit patients who resided in local care and nursing homes to improve diagnosis of 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 and had attended mental capacity awareness training.

• All practice staff had received ‘Dementia Awareness’ training.

Updated 5 May 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 homeless people, travellers, those with a learning disability and those suffering domestic violence.

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

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

• 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.