Archived: Dr Richard Pool Also known as Greenfield Surgery

Updated 28 October 2016

The practice is also known as Greenfield Surgery and is based in a converted residential property. The practice holds a contract to provide general medical services and at the time of our inspection there were approximately 2,200 patients on the practice list. The practice has a slightly higher than average number of patients from 40 to 59 years and over 85 years, there is a slightly lower than average number of patients from birth to four years, 20 to 34 years and 60 to 84 years old. The practice has a lower than average number of patients with long standing health conditions. The practice is located in an area that is considered to be in the least deprived centile nationally but has a slightly above average number of older people affected by income deprivation. The practice also provides GP services for refugees who are housed locally.

The practice has two GP partners (one male and one female). They are supported by one practice nurse and a small team of clerical and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are offered 7:30am to 8am Wednesday to Friday. When the practice is closed patients are advised to call NHS 111 where they will be given advice or directed to the most appropriate service for their medical needs.

The service is provided from the following location:

177 High Street

Old Woking

Woking

Surrey

GU22 9JH

The practice is in a transitional period from a single handed GP practice to a partnership, the change of registration process has been started with CQC.

Updated 28 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Richard Pool on 1 September 2016. Overall the practice is rated as good.

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

• 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.
• 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.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, however not all incidents were recorded.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks, training and storage of cleaning equipment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice is in the process of transitioning from a single handed GP to a partnership and as a result there wasn’t a clear leadership structure however staff felt informed and 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 must make improvement are:

• Ensure that there is a robust system in place for recording significant events.
• Ensure recruitment arrangements include all necessary employment checks for all staff, including temporary staff.
• Ensure that storage areas are suitable and equipment stored appropriately, including the cleaners cupboard.
• Ensure that GP and staff training is monitored to ensure that training appropriate to job role is completed including that all GPs have completed level three safeguarding children training.

The areas where the provider should make improvement are:

• Ensure that the leadership structure is communicated to all staff and roles and responsibilities are clear.
• Ensure that a confidentiality agreement is in place for third parties including buddy practice.
• Continue to pro-actively identify carers and ensure that they are identified on the clinical system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 October 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.
• 82% of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less which is comparable to the local average of 80% and the England average of 78%.
• 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 28 October 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.
• 76% of eligible female patient’s notes recorded that a cervical screening test had been performed in the preceding five years which is comparable with the England average of 82%.
• 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 28 October 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 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 28 October 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.

Updated 28 October 2016

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

• 92% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• 100% of patients with severe and enduring mental health problems had a comprehensive care plan documented in their records within the last 12 months which was comparable to the CCG average of 91% and the national average of 88%.
• 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.

Updated 28 October 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 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 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.