Archived: Satis House

Updated 7 August 2017

Satis House is a purpose-built GP practice located within the village of Water Orton, which is in North Warwickshire and close to the boundary of Birmingham. The practice is part of the NHS Warwickshire North Clinical Commissioning Group (CCG).

Satis House is an Alternative Provider Medical Services (APMS) practice and forms part of the Malling Health organisation, which is incorporated within the Integral Medical Holdings Group network.

The practice serves patients in Water Orton, and the nearby villages of Coleshill, Curdworth, Blythe End and some parts of Shustoke and Lea Marston. Patient list size is currently 3,717. The practice’s population is almost all White British (96%) or White Irish (2%), with other ethnic groups representing less than 1% of the population. The practice has a higher proportion of patients aged 45 to 74 years than the local (CCG) or national average.

The clinical staff team consists of two female GPs (one lead and one salaried), two practice nurses, and one healthcare assistant. The practice uses locum GPs, including male GPs who work at the practice regularly, thereby offering patients the opportunity to be treated by a clinician of the same gender.

The clinical team was supported by two joint practice managers, a medical secretary, and a team of five reception and administrative staff.

The practice building and telephone lines are open from 8am to 6.30pm on weekdays. The practice is not open at weekends. Appointments are available on weekday mornings and afternoons except for Thursdays which is mornings only.

When the practice is closed patients can call the practice telephone number which is then diverted to the local Warwickshire Out of Hours service which is provided by Care UK. Further advice and guidance is provided by the NHS 111 service.

Updated 7 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Satis House on 16 June 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.

• We saw evidence that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• Patients we spoke with 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.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints, concerns and patient feedback.

• 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 area where the provider should make improvements is:

• The practice should ensure they have systems in place to consistently manage and document medicine review dates, and to consistently record outcomes of blood tests in patient records.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 August 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was similar to CCG and national averages. For example, the percentage of patients with diabetes whose last measured total cholesterol was under the recommended level was 84%, compared with the CCG average of 84% and the national average of 80%.

• 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.

Updated 7 August 2017

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

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

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

• The practice worked with midwives, health visitors and school nurses to support this population group. This including providing ante-natal, post-natal and child health surveillance clinics.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 7 August 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. All patients aged 75 years and above had been allocated a GP accountable for their care.

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

• 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.

• Where older patients had complex needs, the practice shared summary care records with local care services.

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

• The practice was monitoring any patient aged 65 years and above who had not seen a nurse or GP during a 12-month period, and was contacting these patients to invite them for a health review.

Updated 7 August 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.

• 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.

• The practice operated online booking and prescription services, and text messages were used to remind patients of their appointment details.

Updated 7 August 2017

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

• Performance for mental health related indicators was in line with or higher than local and national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 100% (all patients). The local average was 95% and the national average was 89%.

• 82% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable with the local average of 85% and the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment. The practice carried out advance care planning for patients living with dementia.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 August 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 homeless people, travellers and 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.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed 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.