Archived: Malling Health @ Foleshill

Updated 21 March 2018

Malling Health @ Foleshill is located on the outskirts of Coventry. The practice is part of the Integrated Medical Holdings (IMH) Ltd. the parent organisation. Clinical staff and the practice manager work across two sites. The practice is based in a purpose built porta cabin, which is managed by NHS Properties Ltd. The practice is situated in an area of higher than average deprivation.

The practice has three salaried GPs (two male and one female), with two practice nurses and one health care assistant (HCA). Members of clinical staff are supported by a practice manager and a team of reception and administrative staff.

The practice is open from 8am to 6.30pm Monday through to Friday. Pre-bookable appointments can be booked up to six weeks in advance and urgent appointments are available between 8am and 10.30am. Extended hours appointments are available Mondays to Fridays between 6.30pm and 9.30pm and on Saturdays from 9am till 12.30pm at a choice of four locations, delivered by the local GP Alliance. Out of hours care is provided by the City of Coventry Out of Hours Service, which is accessed by calling the NHS 111 service.

The practice has an Alternative Primary Medical Services (APMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is part of the Coventry and Rugby Clinical Commissioning Group (CCG). At the time of our inspection 3251 patients were registered.

Updated 21 March 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Malling Health @ Foleshill on 10 January 2017. As a result of our inspection the practice was rated as good overall but required improvement for providing caring services. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Malling Health @ Foleshill on our website at www.cqc.org.uk.

This inspection was a desk-based focused inspection carried out on 7 November 2017 to confirm that the practice had carried out their plan to meet the improvements that we identified at our previous inspection on 10 January 2017. This report covers our findings in relation to those improvements.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice had continued with their recruitment of clinical staff programme and had successfully recruited an additional practice nurse and a salaried GP (40 hours) who was due to commence at the practice on 20 November 2017.
• Action had been taken in response to patient feedback from the National GP Patient Surveys. This included: practice surveys to obtain patients views on their experiences of the services received; patients’ access to appointments, telephone and translation service availability had been kept under review; the installation of additional telephone lines to ease telephone access; and clinical hours had been increased (by 10 hours) to improve consultation time. The practice had achieved a score of 69% for telephone access which compared with the local and national averages of 71%. This was an improvement on the previous years’ score of 46%.
• Data from the National GP Patient Survey published July 2017 showed that improvements had been achieved in how patients rated the practice for several aspects of care. Results were generally above or in line with the local and national averages. For example, 87% of patients said the GP gave them enough time, compared to the Clinical Commissioning Group (CCG) average of 85% and the national average of 86%; and 89% of patients said the last GP they saw or spoke to was good at involving them in decisions about their care, compared to the CCG average of 80% and the national average of 82%.
• The practice had been more proactive with identifying carers and as a result had seen increases in the number of patients with caring responsibilities on their register. There were now 45 carers (previously 20) on the register who could receive support and advice from the practice. This represented 1.4% of the patient population.
• The chaperone procedures for all staff had been reviewed and updated.
• Details on how to complain and the full address of the Parliamentary and Health Service Ombudsman (PHSO) had been added to the practice leaflet so that patients would know who they could contact if needed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 February 2017

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

• Nursing staff had lead roles in some areas of chronic disease management and patients at risk of hospital admission were identified as a priority.
• 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 6 February 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 - accident and emergency (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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The percentage of women aged 25-64 whose notes recorded that a cervical screening test performed in the preceding 5 years was 83% compared to the local average of 85% and the national average of 81%.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 6 February 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.
• Record of contact details for support workers and next of kin were recorded in the patient records.

Updated 6 February 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.
• Online booking and online prescription service are available for patients.
• Signposting to local lifestyle services such as “Help 2 Quit” a stop smoking service were available to patients.

Updated 6 February 2017

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

• 75% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was below the Clinical Commissioning Group (CCG) and national averages.
• 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 6 February 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 patients who were blind or had hearing problems.
• The building complied to the Disability Discrimination Act (DDA), with doors painted darker (to help partially sighted patients), televisions that announced patient names as well as visually and disabled toilet.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.