Archived: Kingswell Surgery

Updated 22 May 2017

Dr John Davies, otherwise known as Kingswell Surgery, is situated within a converted residential building, with a purpose built extension, in the village of Penistone approximately nine miles from Barnsley. This is a dispensing practice which means that prescriptions are dispensed at the practice for patients who do not live near a pharmacy. The building has a small car park and disabled access. The practice provides care for 3,602 patients in the NHS Barnsley Clinical Commissioning Group (CCG) area. The practice catchment area has been identified as one of the ninth least deprived areas nationally.

There are three GPs, two male and one female who are supported by one female practice nurse, two healthcare assistants, a practice manager and a team of administration, dispensing and reception staff.

The practice opening hours are;

• Monday 7.45am to 1pm and 2pm to 7pm.
• Tuesday 7.45am to 1pm and 2pm to 7.30pm.
• Wednesday 7.45am to 12 noon and is closed in the afternoon.
• Thursday 7.45am to 1pm and 2pm to 8pm.
• Friday 7.45am to 12 noon and 1pm to 4pm.

GP appointments are available;

• Monday 8am to 1pm and 2pm to 7pm.
• Tuesday 8am to 1pm and 2pm to 7pm.
• Wednesday 8.30am to 11.30am and closed in the afternoon.
• Thursday 8am to 1pm and 2pm to 8pm.
• Friday 8am to 11am and 1pm to 3pm.

The practice provides extended hours from 8am to 8.30am every morning except Wednesday and 6.30pm to 7pm Monday and Tuesday evenings and 6.30pm to 8pm on Thursday evenings. Patient telephone calls to the practice on Wednesday and Friday afternoons are answered by the practice's own GP on call.

Longer appointments are available for those who need them and home visits and telephone consultations are available as required. When the practice is closed, services are accessed by calling the practice telephone number or NHS 111.

Updated 22 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr John Davies practice on 18 April 2016. The overall rating for the practice was requires improvement and the practice was rated inadequate for being safe. We undertook a focused inspection of the practice on 3 October 2016 and the practice was rated as requires improvement for being safe and well-led. The previous reports can be found by selecting the ‘all reports’ link for for Dr John Davies on our website at www.cqc.org.uk.

This announced comprehensive inspection was undertaken on 3 April 2017. Overall the practice is now rated as good.

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. 
• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider should make improvements.

Importantly, the provider should:

• Review the process for checking emergency medicines to ensure all are reviewed weekly.
• Review the process for tracking blank computer prescription forms and pads to ensure it is in accordance with national guidance.
• Review the process for recording the actions taken in response to national patient safety alerts and medicines recalls.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 22 May 2017

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

• Practice nursing staff had lead roles in long term disease management and patients at risk of hospital admission were identified as a priority. Those who were not able to attend the practice were reviewed in their own home.
• Performance for diabetes related indicators was 98.9% which was 13.7% above the CCG average and 9% above the national average.
• The practice followed up on patients with long term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 22 May 2017

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

• There were systems 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, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors, school nurses and sexual health services to support this population group. For example, the sexual health clinic offered clinics to patients registered at the practice and those from the surrounding area every week.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 22 May 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. The practice care co-ordinator offered support and advice of local services available.

Updated 22 May 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. For example, early morning and evening appointments were offered.
• 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 22 May 2017

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

• The practice carried out advance care planning for patients living with dementia.
• All those patients diagnosed as living with dementia had their care reviewed in a face to face meeting in the last 12 months. This was above the CCG and national average of 84%.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• All those patients with complex mental health issues had their care reviewed in a face to face meeting in the last 12 months. This was above the CCG average of 86% and the national average of 89%.
• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia
• The practice implemented the 'The Herbert Protocol' introduced by South Yorkshire Police, the Alzheimer’s Society, health trusts and Dementia Action Alliances to provide police officers with early access to information when dealing with missing people living with dementia. All patients living with dementia registered at the practice were encouraged to complete the form which was designed to make sure that, if someone was reported missing, the police could access important information about that person as soon as possible. The form contained information about their medical status, mobility, access to transport, places of interest and daily routines. Once completed, copies were made and then available for use if the person should ever be reported missing. The idea is that early access to information will help officers track missing people down quickly.

Updated 22 May 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.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.
• A member of staff had started to act more recently as a carers’ champion to help ensure that the various services supporting carers were coordinated and effective. They would accompany nursing staff on home visits to housebound patients and the visits. The visits were often timed around the staff members lunch break and would, with the patients permission take their lunch with them and stay a little longer.