Broom Road Medical Practice

Updated 12 September 2017

Broom Road Medical Practice is based in the Spring Park area of Shirley, Croydon, a suburban area of south London. It is based in a detached house with free parking available next to the surgery and at the back of the surgery. There is step free access, and reception, two clinical rooms and an accessible toilet are downstairs.

There are two female GP partners, and two long-term male locum GPs. Some of the GPs work part-time. The working hours added together equate to just over two full time roles (whole-time-equivalents).

There is one permanent practice nurse and two nurses employed as long-term locums. There are two female and one male nurse. All of the nurses are female. Some of the nurses work part-time. The working hours added together equate to just over 0.6 of a full time role (whole-time-equivalent). One of the long-term locum nurses is a diabetic nurse and the other has a special interest and extra skills to care for patients with asthma and other respiratory illnesses.

Broom Road Medical Practice works under a General Medical Services contract. The practice is registered with the CQC for the following activities: treatment of disease, disorder or injury, maternity and midwifery services and diagnostic and screening procedures. The practice has signed up to provide some extra services (not normally provided under their contract): childhood vaccination and immunisation, extended hours access, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, learning disabilities, minor surgery, remote care monitoring, rotavirus and shingles immunisation, and unplanned admissions.

The practice is open between 8am and 6.30pm Monday to Friday. Outside of these hours patients are advised to use the NHS 111 service or a local walk-in centre.

Appointments are available on Monday from 8am to 1pm and 5pm to 6.30pm, Tuesday from 8.30am to 11.30 and 4pm to 6.30pm, Wednesday from 8.30am to 10.30am and 3pm to 6.30pm, Thursday from 9am to 11.30am and 2pm to 6.30pm and Friday from 9am to 11 and 1pm and 6.30pm. Extended hours appointments were available until 7.25pm on Monday and Friday.

There are approximately 3,175 patients registered at the practice. Compared to other practices in England, Broom Road Medical Practice has more children and younger adult patients (aged 0 – 20), women aged 35 – 39 and men aged 45 – 49. Compared to other practices in England, the practice has fewer male patients aged 30 – 45 and fewer patients aged over 50 (including older people).

Although Shirley is a relatively affluent area, the practice is based in an area of social housing. The practice population is in the third most deprived decile. The practice population also has higher values on measures of deprivation affecting particular groups, such as children and older people.

Updated 12 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Broom Road Medical Practice on 31 March 2016. The overall rating for the practice was Good. However breaches of legal requirements were found relating to the Safe domain. The practice did not have systems or process to enable them to monitor and mitigate risk relating to health, safety and welfare of service users and others who may be at risk. There was no evidence that electrical wiring had been tested. The last Legionella assessment was completed in 2010. (Legionella is a term for a particular bacterium which can contaminate water systems in buildings). All staff records did not have details of up-to-date mandatory training, for example safeguarding and infection control.

After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report can be found by selecting the ‘all reports’ link Broom Road Medical Practice on our website at www.cqc.org.uk.

This inspection was a focused follow up review carried out on 25 July 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 in our previous inspection on 31 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Following the focused inspection, we found the practice to be good for providing safe services.

Our key findings were as follows:

• The practice had purchased a defibrillator following the initial inspection, and we saw evidence daily logs were kept to check the working status of the defibrillator.

• The practice now ensured that Patient Group Directions (documents that allow nursing staff to give certain medicines and injections) were signed by the doctor instead of the practice manager.

• All staff had completed training in required topics, such as infection control, safeguarding, basic life support, information governance and fire safety. We saw evidence that all staff were up to date with training.

• Since the initial inspection the practice had conducted a Legionella assessment (Legionella is a term for a particular bacterium which can contaminate water systems in buildings). We saw evidence that actions had been followed up.

• The practice had conducted electrical wiring testing. We saw an electrical installation condition report to verify this.

• Portable appliance testing had been conducted, we saw evidence that this had been carried out since the last inspection.

• Since the initial inspection the practice had conducted a fire risk assessment. We saw evidence that action points had been followed up.

• Action points from meetings (including non-clinical meetings) were properly documented and reviewed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 3 March 2017

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.

• Performance for diabetes related indicators was generally similar to other practices, with scores for some indicators above and others below the CCG and national averages. For example:

  • 97% of patients with diabetes had a foot examination and risk classification within the preceding 12 months (compared to the CCG average of 86% and the national average of 88%).

  • 63% of patients with diabetes had well-controlled blood pressure (compared to the CCG and national average of 78%).

• The practice had recently employed practice nurses with special skills to care for patients with diabetes and respiratory conditions.

• 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 3 March 2017

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.

• 75% of female patients aged 25 – 64 had cervical screening, similar to the CCG and national averages (72% and 74%).

• 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 3 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.

Updated 3 March 2017

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.

Updated 3 March 2017

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

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record. This above the national average of 88%.

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded, compared to the national average of 90%.

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

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

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

Updated 3 March 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.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.