The Cedars Medical Centre

Updated 5 July 2016

Cedars Medical Centre is based in the semi-rural village of Alsager in Cheshire; it is a less deprived area as compared with the rest of Cheshire. There were 9400 patients on the practice register at the time of our inspection. The practice has a higher than average number of older patients (60 to 85+ years) and lower than average number of younger patients (birth to 40 years).

The practice is a training practice managed by five partners (three male, two female). Employed are a practice manager, a clinical care coordinator, an advanced nurse practitioner, four nurses, and a health care assistant (HCA), reception and administration staff. The practice is a teaching practice hosting medical students and nurses on placement.

The practice is open 8am to 8pm Mondays, 7am to 8pm Tuesdays and Thursdays, 7am to 5pm on Wednesdays and 7am to 6.30pm on Fridays. Additional extended hours are available alternate Saturday mornings between 9am and 12pm.

Patients requiring GP services outside of normal working hours are referred on to the local out of hours provider N.E.W. operated by the East Cheshire Trust.

The practice has a General Medical Services (GMS) contract and has enhanced services contracts which include childhood vaccinations.

Updated 5 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cedars Medical Centre on 12 May 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. A more effective approach to medication reviews would further reduce risk to patients on some higher risk medications.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. Some patients found it difficult to obtain a pre booked appointment.
• 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.

The areas where the provider should make improvements are.

• Review patient access to pre-bookable appointments.

• Implement a more effective approach to recording and retaining recruitment information.

• Implement a more effective approach to medication reviews.

• Review the approach to the management of safety alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 July 2016

The practice is rated as good for providing services for people with long term conditions.  The practice had registers in place for several long term conditions including diabetes and asthma. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 5 July 2016

The practice is rated as good for providing services for families, children and young people. The practice regularly liaised with health visitors to review vulnerable children and new mothers. 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.

Updated 5 July 2016

The practice is rated as good for providing services for older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and care home visits. The practice participated in meetings with other healthcare professionals to discuss any concerns. A clinical care co-ordinator completed a high proportion of home visits to elderly patients. There was a named GP for the over 75s. 

Updated 5 July 2016

The practice is as rated good for providing services for working age people. The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. There were online systems available to allow patients to make appointments and extended hours from 6.30pm to 7.30pm were available every Monday, Tuesday and Thursday evenings and 7am to 8am every Tuesday, Wednesday, Thursday and Friday mornings.

Updated 5 July 2016

The practice is rated as good for providing services for people experiencing poor mental health. Patients experiencing poor mental health received an invitation for an annual physical health check. Those that did not attend had alerts placed on their records so they could be reviewed opportunistically.  The practice worked with local mental health teams.

Updated 5 July 2016

The practice is rated as good for providing services for people whose circumstances make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability.