Archived: Abbey Medical Practice

Updated 17 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Abbey Medical Practice on 31 May 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However we found that the incident process that the practice had in place had not been adhered to.

• Risks to patients were not fully assessed and well managed.

• The practice was clean and tidy and an infection control audit had been completed.

• Data showed patient outcomes were in line with or above national averages.

• Audits had been carried out that were driving improvements to patient outcomes.
• Patients said they were treated with compassion, dignity and respect.
• The practice had a number of policies and procedures to govern activity, which had been reviewed.
• Safety alerts were received and forwarded to staff in the practice to action as necessary.
• Portable appliance testing had been carried out and equipment had been calibrated and checked.
• Patients were able to get an appointment on the day and were happy with the appointment system and availability.

• Staff said they felt respected, valued and supported.

• All staff that were chaperoning had completed the chaperone training however some staff felt that refresher training would be appropriate.

• Emergency equipment and medicines were available however some of these were found to have expired.

• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse. Policies were in place and training had been undertaken however flagging up of alerts for safeguarding vulnerable adults and children and carers was not always correct or in place.

• There was no robust system in place for the monitoring of high risk drugs, such as methotrexate and lithium. Records did not show an alert that these patients needed monitoring and we saw that patients had not been monitored as required.

The areas where the provider must make improvements are:

• Ensure processes for reporting, recording, acting on and monitoring significant events, incidents and near misses including non-clinical are robust and implemented for all staff to follow.
• Ensure emergency equipment and medicines are monitored and expiry dates are checked.
• Review the current system for the flagging up of alerts for safeguarding vulnerable adults and children and carers and ensure that outstanding safeguarding concerns have been followed up effectively.
• Implement a robust system for monitoring high risk drugs.

In addition the provider should:

• Have a robust system in place to ensure that patients are safeguarded from abuse and improper treatment, including documented discussions with the health visitors regarding children at risk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 July 2016

The practice is rated as good for the care of people with long-term conditions.

• 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 showed the practice had achieved 94% of targets which was higher than the CCG average (91%) and the national average (89%). For example, 99% of patients with diabetes, on the register, have had an influenza immunisation in the preceding 12 months. This was higher than the CCG average (96%) and national average (94%).

• 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 26 July 2016

The practice is rated 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.

• 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.

• The practice’s uptake for the cervical screening programme was 87% which was higher than the CCG average of 85% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• There was a children’s area in the waiting room.

Updated 26 July 2016

The practice is rated good 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 for those with enhanced needs.

• The practice were linked to care homes in the area were they had patients residing at and worked closely with the care home staff to provide reviews and home visits where necessary.

Updated 26 July 2016

The practice is rated 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.

• Telephone consultations were available and the GPs used mobile telephones so the incoming calls were not affected.

Updated 26 July 2016

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

• 90% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the CCG average of 86% and the national average of 84%.  
• 94% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the national average of 88%.

• The practice carried out advance care planning for patients with dementia.

• The practice were able to refer to a mental health nurse.

• 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.

Updated 26 July 2016

The practice is rated 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.

• 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.