Charnwood Surgery

Updated 30 June 2017

Charnwood Surgery is a GP practice providing primary medical services under a General Medical Services (GMS) contract to around 1370 patients within a residential area. The practice’s services are commissioned by West Leicestershire Clinical Commissioning Group (WLCCG).

Charnwood Surgery is located on Linkfield Road in Mountsorrel which is situated between Rothley and Quorn and approximately five miles from Loughborough and seven miles from Leicester. It is on a main bus route between Leicester and Loughborough and the route serves the local villages.

The practice is situated in a wheelchair accessible single storey building and has a small parking area for cars which includes disabled parking. Street parking is also available nearby.

The service is provided by two part time male GP partners who between them provide nine sessions per week. There is also a part time nurse practitioner, a part time practice nurse and a part time phlebotomist. They are supported by a part time practice manager and a team of reception/administration staff. The practice is also a training practice for GP trainees although there were no trainees at the time of our inspection.

The practice is open from 9.00am to 1.00pm and 3.00pm to 6.00pm Monday to Friday with the exception of Thursday when they are open from 9.00am to 12.00pm and closed for the remainder of the day. Appointments are available from 09.00am to 11.30am and from 3.30pm to 6.00pm on Mondays, from 09.00am to11.30am and from 3.30pm to 5.30pm on Tuesday, Wednesday and Friday and from 09.00am to11.30am on Thursdays.

When the practice is closed during the day patients are able to contact one of the GPs via mobile telephone. After 6.30pm patients are able to contact the Out of hours services which are provided by Derbyshire Health United (DHU) via the NHS 111 service. Patients are directed to the correct numbers if they phone the surgery when it is closed.

Updated 30 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Charnwood Surgery on 26 April 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were much higher than local and national averages and showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients who commented on their care 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.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Improve the system for the identification of carers.
• Ensure secondary thermometers are being used in vaccine refrigerators.
• Ensure fire drills are carried out at appropriate intervals.
• Include clinical input for nurse appraisals.
• Ensure cleaning carried out by practice staff is recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 June 2017

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

• Specialist nurses were used to manage long-term conditions.

• Patients at risk of hospital admission were identified as a priority.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for 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.

• Referrals to specialists were made in an appropriate and timely way with referrals done on the spot to avoid any delays in referral and patients given a choice of provider at the same time.

• Patients were able to attend health education events relating to long term conditions through the local federation.

Updated 30 June 2017

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

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children of substance abusing parents and young carers.

• Children and young people were treated in an age appropriate way and recognised as individuals, with their preferences considered.

• Immunisation rates were high for all standard childhood immunisations and non-responders were followed up.

• Appointments were available on the day for children.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• Clinicians kept their knowledge, skills and competences up to date in order to recognise and respond to an acutely ill child.

• Post-partum contraception was provided for mothers at their post-natal check.

Updated 30 June 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• 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. They offered a number of services which we were not commissioned but useful to older people such as ear syringing and simple dressings.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

• All staff were involved in identifying patients who may have benefitted from other support such as those who were experiencing loneliness and were able to refer to a local group who could offer advice and further signpost.

• There was a named accountable GP for all patients which maintained a high level of continuity of care.

• Consideration was given to carer’s needs, for example by securing a patient and their carer in the same care home.

Updated 30 June 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example; they had trialled extended opening hours and found there was a very low take up. Telephone consultations were always available at a time to suit the patient.

• 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.

• Extended services were provided in house reducing the need to travel to hospital.

Updated 30 June 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is much better than the national average.
• Patients at risk of dementia were identified and offered an assessment.
• The practice were members of the national Dementia Action Alliance and had recently completed ‘dementia friends’ training to enable all staff to be able to have a greater understanding of and therefore more able to support patients living with dementia appropriately.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• Care was tailored to patient’s individual needs and circumstances, including their physical health needs. This included annual health checks for people with serious mental illnesses.
• Access to a variety of treatments was facilitated such as listening and advice, cognitive behavioural therapy and counselling.
• The practice utilised a mental health facilitator who was also invited to all multi-disciplinary team meetings
• We saw an example whereby the practice had not felt appropriate secondary care had been given to a patient suffering poor mental health and they had raised this with stakeholders and with the services concerned in order to avoid the same problem reoccurring and try and improve services for patients.

Updated 30 June 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 including those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability or any vulnerability.
• 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 children, young people and adults whose circumstances may make them vulnerable. They 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.

• Information on how to access GP services and support groups was made available through a number of avenues including the practice leaflet, website and social media. The practice aimed for patients to feel able to access their services without fear of stigma and prejudice.
• Longer appointments were offered where required.
• The practice made exceptions to accommodate vulnerable patients; for example by registering a vulnerable care home patient despite their care home quota being at capacity.
• All staff were aware of and used the first contact referral service for vulnerable patients which put them in touch with numerous avenues of support.
• If patients are vulnerable, this is identified in their patient record so all staff are aware.