Background to this inspection
Updated
3 August 2016
The Moir Medical Centre is run by a partnership of three GPs, and provides primary medical services to approximately 13,500 patients. The practice population live in an area which is less deprived than the national average.
The practice holds the Personal Medical Services (PMS) contract to deliver primary medical services.
The practice operates from a main surgery at Long Eaton, a newly built branch surgery at Sawley and a smaller branch surgery at Toton. Patients can attend the services at all three sites.
The clinical team includes three GP partners, two salaried GPs and one long term locum GP. Patients can access male or female GPs. T
he practice employs two advanced nurse practitioners in addition to a nurse practitioner and six practice nurses.
The nursing team are supported by three health care assistants.
The management team includes a practice manager and a deputy practice manager.
The team are supported by reception, administrative and secretarial staff.
The practice is an accredited training practice for GP registrars in training and medical students.
The main practice site opens from 8.00am to 6.30pm Monday to Friday. Appointments are available daily from 8.40am to 6.00pm. Extended surgery appointments are available on Tuesday evenings between 6.30pm and 9.00pm.
The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU).
Updated
3 August 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of The Moir Medical Practice on 27 August 2015. A breach of legal requirements was found in that formal systems were not in place, to assess and control all risks associated with the premises. Overall the practice was rated as good with requires improvement for the safe domain.
After the comprehensive inspection, the practice wrote to us to say what action they had, and were taking to meet the legal requirement in relation to the breach.
We undertook this desk based review on 15 July 2016 to check that the provider had completed the required actions, and now met the legal requirements. We did not visit the practice as part of this inspection. This report only covers our findings in relation to those requirements.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Moir Medical Practice on our website at www.cqc.org.uk.
Our finding across the area we inspected was as follows:
The practice had taken appropriate action to meet the legal requirement.
Overall the practice is rated good including the safe domain.
Formal systems were in place to assess, monitor and minimise all risks associated with the premises, to ensure the services were safe.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
24 December 2015
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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. We saw evidence that the practice had worked to improve the care it delivered in respect of long term conditions, for example data showed that the practice had improved its performance in respect of monitoring of people with high blood pressure.
Families, children and young people
Updated
24 December 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 at risk, for example, children and young people who had a high number of A&E attendances. Staff were able to give examples of how they liaised with the health visiting team if they had concerns about a child. Immunisation rates were relatively high for all standard childhood immunisations and the practice performed particularly well for immunisations at 5 years. Premises were suitable for children and babies, having access for pushchairs and baby changing facilities. We saw good examples of joint working with midwives, health visitors and school nurses including joint meetings.
Updated
24 December 2015
The practice is rated as good for the care of older people.
Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. For example, the practice provided data to show people with osteoporosis were treated appropriately. The practice offered enhanced services to meet the needs of its older population, for example, for patients living with dementia or those requiring end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments as required. The practice had increased its presence in local care homes and was in the process of initiating a regular visiting schedule to try to minimise requests for home visits.
Working age people (including those recently retired and students)
Updated
24 December 2015
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. For example, the practice opened until 9.00pm on a Tuesday evening for pre-booked appointments. The practice was proactive in offering online services as well as a full range of health promotion information that reflected the needs of this age group.
People experiencing poor mental health (including people with dementia)
Updated
24 December 2015
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 management of people experiencing poor mental health, including those with dementia. It carried out advanced care planning for patients with dementia. The practice had worked to improve its systems for the review of patients with dementia. For example, the practice had instigated a regular review of care home patients by a nurse practitioner.
The practice had told patients experiencing poor mental health about how to access appropriate support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Multidisciplinary meetings were attended by the community psychiatric nurse.
People whose circumstances may make them vulnerable
Updated
24 December 2015
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice worked closely with the care coordinator to ensure that the needs of vulnerable patients were well managed in the community. Patients who had been discharged from hospital were reviewed by the care coordinator to consider how any future admissions might be avoided. The care coordinator also ensured that patients’ needs were being met. The care coordinator and practice staff signposted vulnerable patients to appropriate support groups and voluntary organisations. This information was also available in the practice waiting area.
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.