Dr Andreas Tobias Keyser Also known as Albion Surgery

Updated 20 April 2018

Dr Andreas Tobias Keyser’s practice (also known as Albion Surgery) is located in a medical centre in the Everton area of Liverpool which is in a deprived area of Merseyside with high unemployment rates. There were approximately 3,280 patients registered at the practice at the time of our inspection and the majority were white British.

The practice is a teaching and training practice led by an individual GP. There are two salaried female GPs. In addition there are two practice nurses. Clinicians are supported by a practice manager, reception and administration staff.

The practice is open 8am to 6.30pm Monday to Friday. The practice offers evening appointments on Thursdays until 7.30pm.

Dr Andreas Tobias Keyser’s practice has a Personal Medical Services contract (PMS). The practice is part of NHS Liverpool Clinical Commissioning Group (CCG).

Patients accessed the Out-of-Hours GP service by calling NHS 111.

Updated 20 April 2018

This practice is rated as Good overall. (Previous inspection 29 October 2014– Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr Andreas Tobias Keyser’s practice (also known as Albion Surgery) on 26 March 2018 as part of our routine inspection programme.

At this inspection we found:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• 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.
• Care Quality Commission (CQC) comment cards reviewed indicated that 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.
• Results from the national GP patient survey from July 2017 showed that patients’ satisfaction with how they could access care and treatment was in line with local and national averages. Urgent appointments were available the same day.
• 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.

The areas where the provider should make improvements are:

• Update the patient information leaflet on how to make a complaint to include who patients can complain to if they do not wish to complain directly to the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 January 2015

The practice is rated as good for the care of patients with long-term conditions. Two practice nurses supported patients, offering regular appointments to monitor their condition and effects of medications. Repeat prescribing was in place to ensure patients did not run out of medicines, but this was subject to regular review. Blood tests could be conducted on site, rather than patients having to visit the hospital for this service.

Updated 8 January 2015

The practice is rated as good for the care of children and young people. Any new patients registering with the practice received a comprehensive health check and assessment of their needs from the practice nurse.  Any clinical problems identified were referred to a GP who would generally see the patient on the same day if required.  The health check offered by the nurse was also used to identify whether children and young people had received all required vaccinations and immunisations.

Updated 8 January 2015

The practice is rated as good for the care of older people. Historically the practice had a low figure for the identification of older patients with dementia. To address this, the practice conducted a fresh audit on patients who had presented with any related symptoms to ensure any diagnosis of dementia had not been overlooked. Once patients had received a diagnosis of dementia the practice worked with other community health professionals to deliver a holistic package of care and support to those patients. Patients over the age of 75 had a named GP.

Updated 8 January 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of these patients 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 a full range of health promotion and screening which reflected the needs of this age group.  The practice offered extended hours of surgery on Thursday evening, when the practice was open until 7.30pm.

Updated 8 January 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice kept up to date registers of patients experiencing poor mental health. These patients had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had advance care planning for patients with dementia, which included the involvement of care navigators, who supported carers to access the support they required when caring for a person with mental health needs. 

Staff had received training on how to care for people with mental health needs and dementia. This included a visit from the mental health lead clinician for the area, to deliver training on dementia and its effect on patients. All practice staff had received this training, including front-line reception staff.

Updated 8 January 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice served a number of patients living in vulnerable circumstances including homeless people and those with learning disabilities. The practice had carried out annual health checks for people with learning disabilities and offered longer appointments with the GP to ensure enough time was available for discussion of their health needs.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.