Background to this inspection
Updated
11 February 2016
Pasley Road Health Centre - G Singh is a single handed practice in a purpose built building located in Eyres Monsell on the south side of the city. The practice list size is approximately 4600 patients. The practice has purchased some land nearby and will be relocating to a new building in 2016.
The site has car parking and pedestrian access and additional parking is available on the streets near to the practice.
The practice has one GP lead (male) and a salaried GP (female) and a long term locum GP. The practice employs a practice manager, two practice nurses along with four administration staff.
The practice provides GP services under a (GMS) General Medical Services contract.
The practice has an ethnic population and offers interpreters for those that have language difficulties. The practice also covers patients in four care homes.
The surgery is open from 8.00am until 18.30pm Monday to Friday. Extended hours surgeries are on a Saturday from 7am to 12pm. Appointments are available from these times and the GP will stay later to see patients if necessary. Appointments are booked on the day with advance bookable appointments also available with the nurse or GP up to two weeks in advance.
The practice lies within the NHS Leicester City Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.
The practice had not previously been inspected by the Care Quality Commission.
Updated
11 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Pasley Road Health Centre - G Singh on 17 November 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
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Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff reflected on incidents and discussed ways to learn for the future.
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Feedback from patients about their care was consistently and strongly positive.
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The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. For example the Patient Participation Group were involved in the development of the new building and looking at other organisations and services could make use of the building.
- The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
- The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
- Risks to patients were assessed and well managed.
- The practice manager reviewed capacity and patient demand daily and appointments were flexed accordingly to ensure demand was a priority.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
- Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments 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 practice regularly audited processes. There had been 12 audits/reviews completed in the past two years where improvements made were implemented and monitored.
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The practice had appointments every Saturday from 7am to 12pm with the GP or nurse. These could be used for routine appointments or for vaccinations, immunisations if patients were unable to attend during the week.
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Same day appointments were available for children and those with serious medical conditions and to any other patients that telephoned at 8.30am or 12pm.
We saw two areas of outstanding practice including:
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The practice had patient champions. These were two patients that had received treatment from the practice following diagnosis of cancer following screening programmes. Both patients had their photograph on the notice board and their story of how the screening programme and the practice had saved their lives. The patients wanted to share their stories to promote screening and for cancer. The review on screening that had been completed by the practice had seen an increase in all of the screening programmes since the champions had been promoted.
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The practice held an open day each year for all patients. The last open day was attended by approximately 300 patients. The practice provided a lunch on the day and patients were able to access information and have the flu vaccines. This was supported by the PPG and other agencies were invited to attend, for example, Age UK, Police, and Fire Service. This gave the patients and the staff opportunity to meet on an informal basis.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
11 February 2016
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Diabetes related indicators were 84.9% which was similar to the CCG average 85.2% and national average 89.2%.
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Longer appointments and home visits were available when needed.
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All patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
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The practice was a small long established practice and staff were able to identify changes when they saw the patients.
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The practice held regular staff meetings which gave all staff the opportunity to discuss any patients of concern.
Families, children and young people
Updated
11 February 2016
The practice is rated as good for the care of families, children and young people.
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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.
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Immunisation rates were reviewed and clinics had been changed to enable better access for all standard childhood immunisations.
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Patients were able to book for immunisations on Saturday mornings.
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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.
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The practice’s uptake for the cervical screening programme for 2014/15 was 82% which was the same as the national average and above the CCG average of 78.6%.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
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The practice were attempting to engage younger people and had held a young people’s open day, this had a relatively poor turnout which was thought to be due to it been on a Saturday morning. The practice was working with the PPG and local youth centres to establish a more appropriate day and time for this demographic for 2016.
Updated
11 February 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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Older people who were at risk of admission due to age or co-morbidity were identified and flagged on the practice electronic system.
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Practice held an annual ‘open day’ for all patients to attend. The practice provided food and refreshments and patients were able to attend and discuss concerns with practice staff or other agencies and receive vaccinations, such as flu. This helped those people that may feel isolated.
Working age people (including those recently retired and students)
Updated
11 February 2016
The practice is rated as good for the care of working age people (including those recently retired and students).
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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.
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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.
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The practice opened up to 6.30pm every weekday and also provided a surgery on Saturday mornings which was from 7am to 12pm, although if required the GP would stay until 3pm.
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Same day appointments were available by telephoning at 8.30am for a morning appointment and then 12pm for an afternoon appointment.
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Bookings could be made up to two weeks in advance.
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Telephone consultations were available with a GP or nurse.
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Appointments could be booked online.
People experiencing poor mental health (including people with dementia)
Updated
11 February 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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The dementia diagnosis rate was above the CCG and national average at 100% compared with 90.7% and 94.5% respectively.
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The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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The practice worked with a mental health nurse who they were able to refer patients to and would visit the patients in their own home if they wished.
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It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
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Staff had a good understanding of how to support people with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
11 February 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
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It offered longer appointments for people with a learning disability and ensured that appointments ran concurrently were required.
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The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
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It had told vulnerable patients about how to access various support groups and voluntary organisations.
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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.