Westgate Surgery

Updated 31 March 2017

Westgate Surgery provides services from purpose built premises to patients living in and around Westgate Village in Kent. All patient areas are on the ground floor and are accessible to patients with mobility issues, as well as parents with children and babies. There are approximately 10,100 patients on the practice list. The practice has significantly more elderly patients, fewer working aged patients and less patients aged twenty five and under than national averages. For example, there are more patients aged over 85 registered at the practice when compared to the national average (practice 5%, national 3%). The practice told us that a high proportion of their older patients live in care homes.

The practice holds General Medical Service contract and consists of five GP partners (one female and four male). There are two advanced nurse practitioners (one female and one male), four nurses (female) and two healthcare assistants (female).

The practice is part of collaboration with two other local GP practices known as QUEX. QUEX is receiving funding from the local clinical commissioning group (CCG) to provide an over 75’s frailty team. The practice initiated this pilot scheme and continues to host the frailty team which consists of four nurses (female), one of whom is trained as a community matron. Through this pilot the practice has access to two beds in a local residential home which are used by QUEX to prevent hospital admissions.

The GPs and nurses are supported by a practice manager and a team of administration and reception staff. A wide range of services and clinics are offered by the practice including: asthma, diabetes, and minor surgery and child health/baby clinics. There is access to a practice managed audiology service on site.

The practice is open from 8am to 6.30pm Monday to Friday and provides extended hours from 7am to 8am every Wednesday and Thursday.

Services are delivered from:

60 Westgate Bay Avenue,

Westgate On Sea,

Kent,

CT8 8SN.

Updated 31 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westgate Surgery on 26 July 2016. The overall rating for the practice was good but the practice was rated as requires improvement for providing safe services. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Westgate Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 7 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Systems and processes had been implemented to ensure that the storage of vaccines was managed in line with national guidance.
• Blank prescription forms were securely stored and there were systems in place to monitor their use.
• A system had been implemented to help ensure that staff record that they have undertaken the routine cleaning of medical equipment.
• The practice had increased the number of patients identified as carers from 66 to 97, which is 1% of the practice list.
• A system had been implemented for monitoring staff training to help ensure that all members of staff were up to date with training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 October 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.
• Performance for diabetes related indicators were higher than the national average.
• 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 multidisciplinary package of care.
• The practice held multidisciplinary long term conditions meetings which were attended by the community specialist nurses.

Updated 3 October 2016

The practice is rated as good for the care of families, children and young people.

• There were systems 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.
• The practice’s uptake for the cervical screening programme was 85%, which was better than the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice held a Women’s Health Clinic every Wednesday afternoon in recognition that access to these services locally had reduced over recent years. The practice had plans to introduce a similar clinic for male patients.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The PFG and practice had worked together to produce an information leaflet for patients aged under 25.
• The practice had Facebook and twitter accounts so patients from this population group can access information.

Updated 3 October 2016

The practice is rated as outstanding 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 had instigated and hosted an over 75’s frailty team in collaboration with the local clinical commissioning group (CCG) and nearby GP Practices. The scheme facilitated nurse led home visits and access to two beds in a local care home in order to reduce patients being unnecessarily admitted into hospital.
• Patients had access to practice managed audiology service.
• The patient focus group (PFG) and the practice had collaborated to produce an information leaflet for retired patients.
• Care homes were provided with a welcome pack to give to their new residents. These packs included the direct telephone numbers of key members of staff in the practice and registration documents which were tailored to patients living in care homes to help ensure they were registered quickly and efficiently.
• Members of staff from the nursing team had visited local care homes to provide training in how to care for elderly patients. For example, monitoring blood pressure.

Updated 3 October 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 as well as a full range of health promotion and screening that reflects the needs for this age group.
• There were early morning appointments available from 7am Wednesday and Thursday for working patients who could not attend during normal opening hours.

Updated 3 October 2016

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

• 85% of patients diagnosed with dementia had received a face to face care review meeting in the last 12 months, which was the same as the local average and similar to the national average of 84%.
• 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.
• The practice had a system 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.
• The practice had hosted a pilot with the local CCG and four other practices aimed at reducing referrals for patients with mental health conditions to secondary health care. Primary care mental health specialists provided a weekly clinic at the practice, meaning that patients recently discharged from secondary care could access specialist support locally.

Updated 3 October 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 practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.
• Staff had undergone extra training in areas such as hearing awareness and identifying domestic abuse.