Archived: Dr Mary Renton

Updated 3 March 2016

Dr Mary Renton, known locally as Islington House Medical Centre is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post natal care. The practice is situated within the centre of Liverpool. This area has higher than average deprivation scores for income, employment, healthcare and deprivation affecting children and older people. The practice has a Primary Medical Services (PMS) contract with a registered list size of 2240 patients (at the time of inspection). This is a family run practice with two GP partners. The practice has a practice nurse, practice manager and a number of administration and reception staff.

The practice is open between 8am to 6.30pm Monday to Friday with appointments bookable in a variety of ways. Extended access is available from 7am on Wednesday mornings. Home visits and telephone consultations were available for patients who required them, including housebound patients and older patients. There were also arrangements to ensure patients received urgent medical assistance when the practice was closed. If patients called the practice when it was closed, an answerphone message gave the telephone number they should ring to obtain healthcare advice or treatment.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mary Renton known locally as Islington House Medical Centre on 10 December 2015. 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 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.

• 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet peoples’ needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice did not have the required information available to demonstrate the premises and all equipment was fit for purpose. Equipment for use in a medical emergency was not available.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

There were areas of practice where the provider should make improvements. The provider should:

• Undertake a risk assessment for the need to have oxygen and a defibrillator for use in an emergency. To refer to current external guidance and national standards, that encourage practices to have defibrillators and oxygen equipment available for emergency use.

• Establish a system for identifying, assessing and managing risks associated with the building. Information to show the management of electrical, heating, safety and building facilities should be available to ensure the practice complies with statutory requirement to minimise risk. The practice should develop a planned and preventative maintenance programme for the building and this should include the improvements required to the floor of the practice treatment room.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 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. This includes weekly home visits to the housebound patients. 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 medicines 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.

Updated 3 March 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. 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 percentage of patients having a cervical screening test was comparable to national figures. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 3 March 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. It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. In 2015 they reviewed all patients over 75 years and produced a geriatric care plan for all. As part of the local community the practice had developed a close relationship with a scheme named Everton in the Community and patients had attended the dementia programme and stand together programme. Annual reviews of care plans took place with the patient and their carer, ensuring that unmet needs were identified. All older patients received an annual medications review. Annual flu clinics including stalls and information from care agencies and voluntary groups were set up. The practice prides itself on having one of the highest rates of influenza and pneumococcal vaccination uptake. Safeguarding policies and procedures were in place. Support for carers including a carer support pack was available, signposting patients to support agencies and services in the local area.

Updated 3 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students), although this area has high levels of unemployed people. 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. Extended hours were in place with the practice opening at 7am each Wednesday morning. 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. The practice designed and sent out a men’s health letter to reach a population that does not always engage with health services. They also facilitate appointments for cryotherapy, by running lunch time clinics.

Updated 3 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 100% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months compared to 83% nationally. 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.  The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It 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 people with mental health needs and dementia.

Updated 3 March 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 and those with a learning disability. They have a very close relationship with their community matron and District Nurse caseload holder. Meetings were held each Wednesday morning to discuss patients every and review their care. The practice offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. One of the senior GPs helped set up a social isolation project in conjunction with Everton in the Community. 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.