Manchester Road Surgery

Updated 1 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 17 November 2015. A breach of legal requirement was found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet this legal requirement in relation to the regulatory breach of the Health and Social Care Act 2008 (Regulated Activities) 2014, Regulation 19 Fit and proper persons employed.

We undertook this focused desk top review on 4 July 2016 to check that they had followed their plan and to confirm they now met the legal requirement. 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 Manchester Road Surgery on our website www.cqc.org.uk.

Overall the practice is rated Good. Specifically, following the focused inspection we found the practice to be good for providing safe services.

Our key findings across all the areas we inspected were as follows:

• The practice had completed Disclosure and Barring Service (DBS) checks for staff who performed chaperone duties in December 2015 and January 2016 (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
• A fire evacuation drill was completed on 28 January 2016 and the practice have updated their Health and Safety risk assessment to include the requirement to complete a fire drill at least annually.
• The practice provided evidence that a log sheet had been implemented to record the checks carried out on the emergency medical equipment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 14 January 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.  Longer appointments and home visits were available when needed.  All 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. For example, the GPs and practice nurses had regular meetings with the local Diabetic Specialist Physician to discuss and review patients who have diabetes.

Updated 14 January 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. The practice told us that all young children were prioritised and children under one were seen on the same day as requested and children between one and 10 would receive a phone call from the GP within two hours of the request to be seen.

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.  Appointments were available outside of school hours and the premises were suitable for children and babies.  Immunisation rates were high for all standard childhood immunisations.   

Updated 14 January 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 GP home visits and urgent appointments for those with enhanced needs. The practice also offered  home visit appointments with the practice nurse and healthcare assistant to ensure housebound patients received the care and treatment they needed.  The practice worked closely with other health and social care professionals, such as the community nursing team, social workers and a community support worker. The practice also provided services for patients who resided in a local care home for the elderly with visual impairment. 

Updated 14 January 2016

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of this population group 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 offered early morning appointments on a Monday from 7.30am and GP telephone consultations late afternoon for patients who were not able to attend the practice during the day.  The practice offered online services as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 14 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia). 91% of people diagnosed as living with dementia had had their care reviewed in a face to face meeting in the last 12 months. The practice have for the past 10 years allocated all patients living with dementia a named GP. The practice carried out advance care planning for patients with dementia and regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations and had developed a crises leaflet for patients experiencing poor mental health. Staff had a good understanding of how to support people with mental health needs and dementia. The practice also hosted Improving Access to Psychological Therapies programme (IAPT) to support patients’ needs.

Updated 14 January 2016

The practice is rated as outstanding for the care of people whose circumstances may make them vulnerable.  The practice held a register of patients living in vulnerable circumstances including those who had a learning disability.  Longer appointments were available for patients as needed. The GPs carried out routine weekly home visits to patients who were frail or chronically ill even if they were not housebound. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and looked after the residents of a local drug and alcohol rehabilitation care home, providing a weekly routine surgery and acute appointments as required.

The practice had told vulnerable patients about how to access various support groups and voluntary organisations and  offered confidential support through a volunteer chaplain who would support, comfort and signpost patients to local support groups or organisations.  It also offered a listening service run by fully trained volunteers for those patients facing difficult life choices, ill health, loneliness or bereavement. 

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.