Stoneham Lane Surgery

Updated 26 June 2017

Stoneham Lane Surgery is located in a residential area of Southampton, Hampshire. The practice is based in a purpose built centre built in 2014, which is leased from a private landlord. There are ten treatment or consulting rooms on the ground floor and five rooms, including a minor operations suite, on the first floor. The practice is located in an area of average deprivation compared to the average for England.

The practice provides services under a NHS General Medical Services contract and is part of NHS Southampton City Clinical Commissioning Group (CCG). The practice has approximately 7,000 patients registered most of whom live within a five mile radius of the practice. A total of 69% of patients at the practice are working or are in full-time education compared to the national average of 60%.The practice population has a similar number of patients with a long-standing health condition compared to the national average. A total of 57% of patients registered at the practice have a long-standing health condition compared to the national average of 54%.

The practice has two male and two female GP partners as well as employing a salaried female GP. Together, the GPs provide care equivalent to approximately three full-time GPs over approximately 30 sessions per week. The GPs are supported by one full-time nurse practitioner, who is a non-medical prescriber and provides diagnosis, treatment and advice to patients. Three practice nurses and two health care assistant also provide a range of services to patients such as wound care and long-term condition reviews. Together the practice nurses are equivalent to just over three full time nurses. The clinical team are supported by a management team including secretarial and administrative staff. The practice is also a training practice for doctors training to be GPs (GP registrars). At the time of our inspection, the practice was supporting three GP registrars.

The practice telephone lines and reception desk are open from 8am to 6.30pm on Monday to Friday and the reception is open from 7.30am to 6.30pm on Tuesdays and Fridays. Appointments are available between 8.30am and 12.30pm and again from 2pm to 6.30pm daily. Extended hours appointments are offered on Tuesdays and Fridays between 7.30am and 8.30am, every other Monday evening until 8.30pm and on one Saturday per month from 8am until 11am.

Stoneham Lane Surgery has opted out of providing out-of-hours services to their own patients and refers them to the out of hour’s service via the NHS 111 service or the Minor Injuries Unit based in Southampton.

The practice offers a range of additional in-house services to patients including antenatal care, phlebotomy, travel advice, sexual health services and minor surgery. The practice offers online facilities for booking of appointments and for requesting prescriptions.

We carried out our inspection at the practice’s only location which is situated at:

Parkville Road, Southampton, Hampshire, SO16 2JA.

Updated 26 June 2017

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Stoneham Lane Surgery on 25 May 2017 to check that action had been taken since our previous inspection in September 2016. Overall the practice is rated as good.

At our previous inspection, the practice was rated good for Effective, Caring, Responsive and Well Led services and was rated as good overall. However, the practice was rated as requires improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services.

This was because:

• An effective system was not in place to review and action fridge temperatures that exceeded recommended levels for the safe storage of vaccines.
• Patient group directions were not signed by an authorising clinician.
• Vaccines were administered by health care assistants without the correct legal authority.

We inspected the practice on 25 May 2017 to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Stoneham Lane Surgery on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

• The practice had updated its cold chain protocol and now had an effective system to review fridge temperatures by purchasing data loggers and back up thermometers.
• Patient group directions and patient specific directions for administration of vaccines were now correctly authorised.

The practice is now rated good for Safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 November 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.
• Data for patients with long-term conditions were comparable with national figures. For example, the percentage of patients with diabetes, on the register, who had a flu vaccine in the preceding 1 August to 31 March was 100%, compared to a national average of 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 7 November 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. Immunisation rates were relatively high for all standard childhood immunisations.
• 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.
• A total of 78% of eligible women attended for a cervical smear in 2014-2015. This is similar to the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 7 November 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 patients in its population.
• Performance indicators for conditions commonly found in older patients were comparable to national averages. For example, 97% percentage of patients who had a stroke were treated with appropriate medicines compared to a national average of 97%.
• The practice used an alerting system on the records of older patients who had limited mobility and provided appointments in a ground floor consulting room.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• Older patients were actively identified and supported by a dedicated team conducting extended assessments to ensure this patient groups’ needs were met.

Updated 7 November 2016

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 reflects the needs for this age group.
• A text messaging service for reminders to attend appointments and routine reviews was offered to patients.

Updated 7 November 2016

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

• A total of 98% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the preceding 12 months was 90% compared to a national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients living with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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.
• The practice were working towards becoming a ‘dementia friendly’ practice and had undergone training and made changes to the practice environment. For example, the practice used diagrams on signs to make it easier for people with dementia. The practice told us they hoped to be awarded this status in autumn 2016.

Updated 7 November 2016

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.
• The practice had 51 patients with a learning disability. All were offered an annual review in 2015-2016; 82% of patients accepted the annual check.
• 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 informed vulnerable patients about how to access various support groups and voluntary organisations.
• 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.