Rock Healthcare Limited

Updated 20 August 2015

Rock Healthcare is situated in Bury town centre and close to the M66 motorway. At the time of this inspection we were informed 3,775 patients were registered with the practice.

The practice consisted of three salaried GPs (one female and two male). The GPs are providing general medical services to registered patients at the practice under an alternative provider medical services (APMS) contract. The practice is a “not for profit” limited company. The GPs are supported in providing clinical services by a practice nurse, a nurse practitioner and two health care support workers (HCSW) all of whom are female. Clinical staff are supported by a director of practice management and their team who are responsible for the general administration, reception and organisation of systems within the practice. The practice provides appointments from 8am to 8pm, 365 days a year.

Out of hours service is provided by Bury and Rochdale doctors on call (BARDOC).

Updated 20 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rock Healthcare on 14 May 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be good for providing safe, effective and caring services. We found it to be outstanding for being responsive and well led. It was also outstanding for providing services for all the population groups that we assess.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.
• 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.
• Patients said they usually found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had very good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

The areas where the provider should make improvements are:

• The practice should introduce a documented “cold chain” policy to ensure the safety of temperature sensitive medication.

We saw several areas of outstanding practice including:

• The practice had increased the flexibility of access to appointments and use of co-located services and could demonstrate the impact of this by reduced use of the out of hours service and very positive patient survey results. The practice provided appointments between 8am and 8pm 365 days a year.
• The practice had a very good skill mix which included advanced nurse practitioners (ANPs) and was able to see a broader range of patients than practice nurses.
• The practice had continually reached out to the local community by approaching local bail hostels and centres for the treatment of addiction and ensured anyone attending the practice would be seen by a clinician even if they were not a registered patient.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 August 2015

The practice is rated as outstanding for the care of people with long-term conditions. Clinical staff had lead roles in 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 that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Self-empowerment was promoted so that patients could be more involved in their own health management and improvement.

Updated 20 August 2015

The practice is rated as outstanding 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. Immunisation rates were 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 at weekends, with a location based midwife service being available. We saw good examples of joint working with health visitors and outreach clinics.

Updated 20 August 2015

The practice is rated as outstanding for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice successfully gained additional finance to undertake multi-agency work to improve the quality of care for older people.

Updated 20 August 2015

The practice is rated as outstanding 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 20 August 2015

The practice is rated as outstanding for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia and GP demonstrated sound knowledge around patients who lacked capacity to make their own decisions.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia and patients are referred to a memory assessment clinic when appropriate.

Updated 20 August 2015

The practice is rated as outstanding 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, asylum seekers and those with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.