Archived: Ashfield Road Surgery

Updated 23 October 2017

Ashfield Road Surgery is registered with the Care Quality Commission (CQC) as a partnership and provides services over two sites within the Wolverhampton area. The main practice is based at Ashfield Road Surgery and the branch is located at, Pendeford Health Centre. For this inspection a visit was made to the main site. There is access via a ramp at the main site. Services are provided to patients on the ground floor at each of the premises and all areas are easily accessible by patients with mobility difficulties, patients who use a wheelchair and families with pushchairs or prams.

The practice has a General Medical Services contract with NHS England to provide medical services to approximately 5,152 patients over the two sites. It provides Directed Enhanced Services, such as childhood vaccinations and immunisations, minor surgery and extended hours.

The practice team consists of two GP partners, one male and one female. Both GPs work nine to ten sessions each per week. Two advanced nurse practitioners who work part time and a practice nurse who also works part time support the GPs. Clinical staff are supported by two practice managers and five administration / receptionist staff. In total there are 12 staff employed either full or part time hours to meet the needs of patients across both sites. The practice also uses a regular locum GP to support the practice and meet the needs of patients at times of absence.

The main practice Ashfield Road Surgery is open Monday to Friday between 8.45am and 1pm and 2pm to 6.30pm except Thursday when the practices closes at 1pm. The branch is open Monday to Friday from 9am to 1pm, 1.30pm to 6pm on Tuesday and 2pm to 6pm Monday, Wednesday and Friday. The branch practice is also closed on Thursday afternoon. Appointments times for patients vary for the GP and nurses and include both morning and afternoon clinic sessions. The practice offers extended hours appointments on a Saturday morning. The practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out of hours service Vocare via the NHS 111 service.

Updated 23 October 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Ashfield Road Surgery on 7 November 2016. After the comprehensive inspection, the practice was rated as requires improvement for providing safe services.

We issued a requirement notice in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014 Safe care and treatment.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ashfield Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 27 September 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified at our previous inspection on 7 November 2016. This report covers our findings in relation to those requirements.

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

• Risk assessments had been completed on cleaning products used at the practice to prevent staff and patient exposure to substances that could be hazardous to their health.
• Arrangements for the ongoing monitoring of significant events to prevent further occurrences and ensure that improvements made were appropriate were reviewed. The recording of significant had improved and contained relevant information.
• Policies and procedures had been updated to provide staff with clear guidance on the action they should take to check the fridge in the event of a power failure.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

At this inspection we found that the practice had addressed all the concerns raised and is now rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 2017

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

• The GPs and nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The GPs and nurses worked with relevant health care professionals to deliver a multidisciplinary package of care to patients with complex needs.
• The practice performance in diabetes related clinical indicators for 2015/16 was lower than the local CCG and England averages. For example, the percentage of patients on the diabetes register, in whom a specific blood test to get an overall picture of what a patients average blood sugarlevelshad been over a period of time was 66% compared with the CCG average of 75% and England average of 78%. The practice exception reporting rate of was lower than the local CCG and England averages. The practice provided data that showed improvements had been made and to date performance had increased to 90%.
• Longer appointments and home visits were available when needed.

Updated 31 March 2017

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

• Immunisation rates were similar overall 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.
• The practice had access to health visitors to discuss childhood development, immunisations and pre-school checks.
• Community midwives carried out an antenatal clinic one morning per week to support the care of pregnant women,
• The practice’s uptake for the cervical screening programme of 73% was lower than the local Clinical Commissioning Group (CCG) average of 78% and the England average.
• Protected daily appointments were available for children of all ages and children aged under the age of one were given priority and seen on the day. Appointments were available outside of school hours and urgent appointments were available for children.

Updated 31 March 2017

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

• The practice maintained a register of housebound older patients and older patients who required a home visit.
• Older patients were offered urgent appointments for those with enhanced needs.

Updated 31 March 2017

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

• The practice offered on telephone consultations.
• The practice offered extended clinic appointments on Saturday mornings for working patients who could not attend during the normal opening hours. Plans were in place to carry out a trial of additional early morning and late evening extended hours.
• The practice was proactive in offering online services which included making online prescription and appointment requests.
• Patients were sent telephone texts to remind them about their appointment.
• Patients were signposted to a full range of health promotion and screening that reflects the needs for this age group.

Updated 31 March 2017

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.
• 84% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was the same as the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice held a register of patients who experienced poor mental health. Clinical data for the year 2015/16 showed that only 40% of patients who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months. This was lower than the national average of 89%. The practice had looked at this and determined that the data was inaccurate due to inaccurate coding of patients.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 31 March 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice supported patients who abused substances that could harm their health and wellbeing and provided health, social and professional support.
• The practice held a register of 19 patients with a learning disability and offered this group of patients’ longer appointments.
• The practice was alerted to patients whose circumstances may make them vulnerable or may present a risk to ensure that they were registered with the practice if appropriate.
• The practice had told vulnerable patients about how to access various support groups and voluntary organisations.
• The practice regularly worked with other health care professionals in the management of vulnerable patients.