Archived: Resolution Health Centre

Updated 28 February 2018

Resolution Health Centre, North Ormesby Health Village, North Ormesby, Middlesbrough, Cleveland, TS3 6AL, is situated the outskirts of Middlesbrough. The practice is housed in a purpose built medical centre which is not owned by the practice. There is parking with some of the patients living within walking distance and there is access to public transport. There are 5436 patients on the practice list.

There are five salaried GPs three male and two female. There are two nurse practitioners, and one health care assistant. There is a practice manager, and administrative staff. The practice works closely with the clinical commissioning group (CCG) and is part of South Tees Hospitals NHS Foundation Trust. The practice is open from 8am to 6pm, Monday to Friday. Appointments can be booked by walking into the practice, by the telephone and on line.

From 6pm until 9.30pm, when the practice is closed The South Tees Access and Response (STAR) service is used. Patients ring 111 for an appointment. The practice, along with all other practices in the South Tees CCG, area have a contractual agreement for ELM Alliance to provide OOHs services from 9.30pm. This has been agreed with the NHS England area team. The practice has opted out of providing out of hours services (OOHs) for their patients.

Updated 28 February 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Resolution Health Centre on 14 December 2016. The overall rating for the practice was good but requires improvement in safe. The full comprehensive report of the 14 December 2016 inspection can be found by selecting the ‘all reports’ link for Resolution health Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 December 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 on 14 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good.

Our key findings were as follows:

• Since the previous inspection the practice had purchased and installed data loggers (automatic temperature monitors) within the vaccine fridges. We did however find that there were some gaps in recording of fridge temperatures. Also that the data from the data loggers showed the temperatures had gone out of the required range and had not been identified.

• Since the last inspection the practice had implemented additional checks in respect of infection prevention and control. However, no full infection control audits have been completed.

  The provider MUST make improve;

Have effective arrangements in place to ensure that vaccines and other medicines stored in the refrigerators are stored at the correct temperatures.

The practice SHOULD:

• Implement infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 April 2017

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. There was a joint approach in managing these patients with community and district nurses. The practice promoted self-management by using care plans for asthma and Chronic Obstructive Airways Disease (COPD).

• Patients with COPD, asthma and diabetes were managed by nurse led clinics and GPs. Nationally reported data for 2015/2016 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 87% compared to the national average of 82% and the CCG average of 80%.

• Longer appointments and home visits were available when needed.

• Patients with a long term condition had a named GP and a structured annual review to check their health and medicine needs were being met.

• The practice promoted self-management for some long term conditions and referred patients for ongoing support where required.

Updated 13 April 2017

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

• Immunisation rates for 2015/2016 were comparable to or slightly below the local CCG and England average for all standard childhood immunisations. For example, immunisations given to children aged 12 months, 24 months and five years in the practice ranged from70% to 90% compared to 86% to 96% for the local CCG area and 81% to 95% for England.

• 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.

• Nationally reported data from 2015/2016 showed the practice’s uptake for the cervical screening programme was 73% compared to the local CCG average of 82% and national average of 81%. We saw examples of systems in place to promote cervical screening to women throughout the practice in the form of posters.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered a walk-in service between 8am and 8pm for all registered and non-registered patients seven days a week.

• We saw positive examples of joint working with multidisciplinary teams, including midwives, health visitors and school nurses.

• The practice provided access to contraception and screening for sexually transmitted diseases (STDs).

• The practice offered six week post-delivery checks for mothers and babies.

Updated 13 April 2017

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.

• All patients over 75 had a named GP. At the end of each year the practice identified all patients over 75 years of age who have not been reviewed and sent them a specific invitation for a health review.

• The practice was responsive to the needs of older people, and offered home and urgent appointments for those with enhanced needs.

• The practice had identified and reviewed the care of those patients at highest risk of admission to hospital. Those patients who had an unplanned admission or presented at Accident and Emergency (A&E) had their care plan reviewed. Care plans were regularly reviewed and discussed.

• The GPs reviewed NHS 111 contacts and planned follow up care as necessary.

Updated 13 April 2017

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 reflected the needs for this age group.

Updated 13 April 2017

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

• Nationally reported data from 2015/2016 showed 71% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the previous 12 months, compared to the local CCG average of 84% and the national average of 84%. The current monthly monitoring indicated a rise to a 100 % of patients that had received a face to face review.

• Nationally reported data showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 21%, this was 68% below the local CCG average and 67% below the national average. The current monthly monitoring showed 45% of patients now had a care plan documented.

• The practice undertook regular patient reviews in their own home or in the surgery. Those patients who had not attended were followed up with an invitation letter or with a phone call.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The practice has a direct line of communication with an identified member of the mental health team.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Patients suffering acute mental health issues were seen on the same day and had access to the local crisis team.

• 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.

• Patients on medicines requiring regular monitoring and where the practice shared their care with mental health services were monitored regularly.

Updated 13 April 2017

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 and provided a supportive and non-judgemental approach. Examples of these patient groups were people with drug and alcohol problems and those living with a learning disability.

• The practice offered longer appointments for patients with a learning disability. Annual reviews for this group were monitored by the practice, all eight patients on the register had received an annual review.

• The practice held regular Gold Standards Framework (GSF) palliative care meetings to discuss and agree care plans. This involved the practice working together as a team and with other professionals in hospitals, hospices and specialist teams to provide the highest standard of care possible for patients and their families.

• The practice had a large cohort of patients whose first language was not English and had systems in place to meet the needs of this patient group.

• The practice provided the violent patient service across the area and had developed good systems to provide the service effectively.