Beechwood Surgery

Updated 14 May 2018

Beechwood surgery is based in Thornton Cleveleys, Lancashire. The practice is part of Fylde and Wyre Clinical Commissioning Group (CCG) and delivers services under a General Medical Services contract with NHS England

We did not visit the practice during this inspection but conducted a desk top review of evidence sent to us by the practice.

There are approximately 2400 patients on the practice list. The majority of patients are white British. A high number of patients have a long-standing health condition (71% compared to the national average of 53%) and 31% of patients are aged over 65 years compared to the national average of 17%. Male life expectancy is 79 (same as national figure) and female life expectancy is 82 (1 year less than national figure).

Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

There is easy access to the building and disabled facilities are provided. Consultation rooms are across the ground floor. There is a car park behind the building. There is one male GP and one regular male locum GP. There are two female practice nurses and one female health care assistant. There is a practice manager and a team of administrative/reception staff. The practice is a teaching practice for medical students.

The practice opening times are 8am until 6.30pm Monday to Friday. Extended hours are available until 8pm on Monday evenings.

Patients requiring a GP outside of normal working hours are advised to call NHS 111 service to access the out of hours service provided locally by Fylde Coast Medical Services.

Updated 14 May 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on Beechwood Surgery on 08 June 2017. The overall rating for the practice was good, although the practice was rated as requires improvement for safety. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for Beechwood Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 28 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach identified in the requirement notice.

The practice is now rated as good for safe services, and overall the practice is rated as good.

Our key findings were as follows:

• The practice had taken action to address the concerns raised at the CQC inspection in June 2017. They had put measures in place to ensure they were compliant with regulations.
• Appropriate arrangements were in place to ensure staff were recruited safely.
• The practice had improved risk assessment arrangements; fire safety checks were completed and recorded; blind cords had been risk assessed and systems to monitor the schedule of cleaning by the outside agency employed by the practice had been introduced.

The areas where the provider should make improvements are:

• Continue to ensure risk mitigating actions are completed and recorded in a timely manner

• Cleaning schedules should be sufficiently detailed to reflect high risk areas of the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 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 when compared to the local and national average. For example, the percentage of patients who had their blood sugar levels well-controlled was 86% compared to the local average of 84% and national average of 78% and the percentage of patients with blood pressure readings within recommended levels was 79% compared to the local average of 82% and national average of 78%.

• 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.

• 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 8 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.

• 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.

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

Updated 8 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.

• 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.

Updated 8 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, for example, extended opening hours on Monday evenings.

• 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.

Updated 8 August 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.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• Performance for mental health related indicators was variable when compared to the local and national average.For example, 74% of people experiencing poor mental health had a comprehensive, agreed care plan documented in the record compared to the local average of 88% and national average of 89% and 100% of patients diagnosed with dementia had their care reviewed in a face-to-face review compared to the local average of 83% and 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 had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• Two members of staff were due to attend Dementia Friends training.

Updated 8 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 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.