Dr Cooney & Partners Also known as St Helens Medical Centre

Updated 13 June 2016

Dr Cooney & Partners, also known as St Helens Medical Centre, is located in a purpose built medical centre at Upper Green Road, St Helens, Ryde, Isle Of Wight, PO33 1UG.

This practice has a branch at 55a Foreland Road, Bembridge, Isle of Wight, PO35 5UA. During this inspection we did not visit the branch surgery.

Dr Cooney & Partners has an NHS General Medical Services contract to provide health services to approximately 6300 patients in and around Ryde and St Helens and surrounding areas. The practice covers a mixed urban and rural population. The practice has an higher than England average for males and females over 65years and is in the second least deprived decile.

Older people account for the largest group of registered patients at the practice. In identifying the needs specific to this group and through working collaboratively with care homes, statutory and voluntary services, the practice is able to support the health and wellbeing of older people to meet a range of health and social needs. The practice is placed in the second least deprived level of deprivation.

The practice had car parking at the front of the building and a self-check in system. There were consulting and treatment rooms on the ground floor and consulting rooms on the first floor which could be accessed by stairs and a stair lift. The waiting areas were clean and tidy with patient information boards and leaflets. The practice had a room off of the waiting area where patients could take their own blood pressure using a blood pressure machine; this room could also be used for patients who wanted a private conversation with a member of staff.

The practice has four GP partners, two male and two female. The practice has two advanced nurse practitioners, two practice nurses, two healthcare assistants and a community care liaison nurse.

The clinical team are supported by a practice manager and a team of 12 receptionists, and administration support staff.

The practice is open Monday to Friday 8am to 6:30pm and operates extended hours clinics on Saturdays 8.30am to 12 midday or 9am to 12.30pm by appointment only. Phone lines are open from 8.30am to 6.30pm Monday to Friday (excluding public holidays).

Same day appointments can be booked at any time from 8.30am on the day the patients needed the appointment for.

Urgent appointments were also available for people who needed them. Appointments could be made by phone, on line or by visiting the practice. The practice offered online booking of appointments and requesting prescriptions.

The practice offered telephone consultation appointments with the GP or nurses which could be arranged via the reception team. The practice also offered home visits if required and appointments with the practice nurses if the patient felt they did not need to speak with a GP.

The practice has opted out of providing out-of-hours services to their own patients and refers them to the Out of Hours service via the NHS 111 service.

Updated 13 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Helens Medical Centre on 10 March 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.
• 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 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.

We saw one area of outstanding practice:

There was a practice outreach team comprised of a practice funded Community Care Liaison Nurse (CCLN) and a healthcare assistant who worked with patients over the age of 75, referred by the practice staff, outside agencies and those who self-refer to support of the needs of older people. The role of the healthcare assistant was to undertake health checks, with the aim of avoiding admission to hospital, provide care planning, work with patients pre and post dementia diagnosis and with patients in their own homes to avoid a crisis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 June 2016

The practice is rated as good for the care of patients 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.
• Patients with Chronic Obstructive Pulmonary Disease (COPD) and asthma have self-management plans. Admission avoidance care plans are in place where appropriate.
• 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.

Updated 13 June 2016

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

• 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• 74% of patients diagnosed with asthma, on the register, had had an asthma review in the last 12 months compared with the national average of 76%.
• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• 82% of women patients aged 25-64 years had received a cervical screening test in the preceding five years. This was comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses. A nominated GP visits and supports a local boarding school on a weekly basis.
• Experienced Advanced Nurse Prescribers are available every day to see minor illness and practice nurses see children presenting with minor injury.

Updated 13 June 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• There is an outreach team comprising a Community Care Liaison Nurse (CCLN) and a health care assistant (HCA) who work with patients over the age of 75 , referred by the practice staff, outside agencies and those who self-refer to support of the needs of older people. The CCLN  was funded by the practice after a pilot was completed and the practice felt that the benefits to patients was such that the role should continue.
• The HCA works both in the practice and in the community with the CCLN under taking health checks, contributing to admission avoidance care planning, working with people pre and post dementia diagnosis and with people in their own homes to avoid a crisis.

Updated 13 June 2016

The practice is rated as good for the care of working-age patients (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.
• The practice offered a ‘Commuter’s Clinic’ on Saturday mornings for working patients who could not attend during normal opening hours.

Updated 13 June 2016

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

• 96% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 85%.
• 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 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.
• Home visits for mental health reviews and dementia reviews are undertaken when necessary for patient benefit.

Updated 13 June 2016

The practice is rated as good for the care of patients 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.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams 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.
• The practice registered patients of no fixed abode and see patients as temporary residents who present with an urgent social or medical need.
• The GPs or outreach team offer bereavement visits and support following bereavement.