Archived: Dr G Celikkol's Practice Also known as Grange Park Health Centre

Updated 30 January 2017

Dr G. Celikkol’s Practice is situated in Grange Park Health Centre in Dinmore Avenue in the Normoss area of central Blackpool at FY3 7RW, serving an urban population. The building is a purpose-built health centre with good parking facilities and the practice is located on the ground floor. The practice provides level access to the building and is adapted to assist people with mobility problems. The practice also has a branch surgery in a detached house in Chain Lane, Staining, also in Blackpool at FY3 0DD. We did not visit the branch site as part of this inspection. Both practice sites are close to public transport.

The practice is part of the NHS Blackpool Clinical Commissioning Group (CCG) and services are provided under a Personal Medical Services Contract (PMS). There is one male GP (the registered provider) and one female long-term locum GP. The practice also employs one practice nurse and is supported by non-clinical staff consisting of a practice manager and five administrative and reception staff. A clinical pharmacist who is employed by the CCG also supports the practice.

The practice is open at Grange Park between 8.30am and 6pm Monday to Friday except Wednesday when it closes at 3.30pm. Opening hours at Staining are Monday to Friday 9am to 1.30pm and 2:30pm to 6:30pm. Appointments with a GP are offered from 10.30am to 12.20pm and from 4.30pm to 5.30pm at Grange Park every weekday except Wednesday, when appointments with a GP start at 9am and finish at 12.20pm. Appointments at Staining are from 6pm to 6.30pm every weekday. The practice also offers late appointments at Staining for emergencies between 6.30pm and 7pm. When the practice is closed, patients are able to access out of hours services offered locally by the provider Fylde Coast Medical Services by telephoning 111.

The practice provides services to 2,265 patients The practice population comprises of fewer patients over 65 years of age (12%) than the CCG average of 20% and the national average of 17%, and more patients under 18 years of age (24%) than the CCG average of 19% and the national average of 21%.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Both male and female life expectancy is lower than the national average, 79 years for females compared to 83 years nationally and 74 years for males compared to 79 years nationally.

The practice caters for a higher proportion of patients experiencing a long-standing health condition (57%) compared to the national average of 53%. The proportion of patients who are in paid work or full time education is lower (51%) than the CCG average of 54% and the national average of 62% and unemployed figures are also lower, 3% compared to the CCG average of 5% and the national average of 4%.

Updated 30 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Celikkol’s Practice on 6 December 2016. Overall the practice is rated as good.

At our previous comprehensive inspection carried out on 21 April 2016 the practice was found to be in breach of three regulations. Shortfalls identified included a lack of effective safety systems, inadequate arrangements to deal with medical emergencies, shortfalls in staffing provision and staff training, deficiencies in clinical practice and inadequate governance arrangements. The practice was place into special measures.

This inspection carried out on 6 December 2016 found that the practice had made significant improvements and that they were meeting all the required regulations.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed. The practice had yet to implement the action plan to mitigate risks identified in the legionella risk assessment and told us that they were about to address this.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients praised the thorough nature of GP consultations.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• All staff had had an annual appraisal except for two which we were told were planned for December 2016.
• 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 and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Implement the action plan associated with the legionella risk assessment.
• Complete the staff annual appraisal process for the two staff members who have not yet been appraised.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 January 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 better than the local and national averages. For example blood measurements for diabetic patients showed that 85% of patients had well controlled blood sugar levels compared with the local average of 83% and national average of 78%.
• The practice was working proactively to identify those patients who had not been added to practice patient chronic disease registers to ensure that they received appropriate care and treatment.
• 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 30 January 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.
• 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’s uptake for the cervical screening programme was 66%, which was worse than the local average of 71% and the national average of 74%. We saw that the practice actively encouraged patients to attend for this screening.
• 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 30 January 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.
• Patients at risk of unplanned admission to hospital had an agreed recorded care plan in place to support them and their carers to take appropriate action when the patient’s health needs deteriorated. The principal GP contacted them when they were discharged from hospital.
• The Citizens Advice Bureau visited the practice twice a week and offered advice to patients in the local area. Practice patients and other patients in neighbouring practices were able to book appointments for this.
• The practice had implemented a new procedure to encourage patients to attend bowel and breast cancer screening.

Updated 30 January 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.
• Appointments were offered at the Staining branch site between 5.30pm and 6.30pm every weekday.
• 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.
• There were telephone appointments available for patients.

Updated 30 January 2017

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

• 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had an agreed care plan documented in their record compared to the local average of 95% and the national average of 89%.
• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is higher than 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 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.
• 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 and had undertaken training in dementia awareness.

Updated 30 January 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.
• The practice offered longer appointments for patients with a learning disability and those with complex needs.
• 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 told us that translation services were available for patients who did not have English as a first language. There were stickers on all staff computers to advertise this service and provide contact details.
• The practice had a guide dog policy to allow guide dogs to enter the premises when necessary.
• The practice asked all new patients to identify any communication difficulties and indicate preferred method of communication with the practice.
• 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.