- GP practice
Archived: Manor House Surgery Hadfield
All Inspections
11 January 2018
During a routine inspection
This practice is rated as Outstanding overall. (Previous inspection April 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Outstanding
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Outstanding
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 – Outstanding
People with long-term conditions – Outstanding
Families, children and young people – Outstanding
Working age people (including those recently retired and students – Outstanding
People whose circumstances may make them vulnerable – Outstanding
People experiencing poor mental health (including people with dementia) Outstanding
We carried out an announced comprehensive inspection at Manor House Surgery Hadfield on 11 January 2018 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw several areas of outstanding practice including:
- The practice used new tools and tests to improve outcomes for patients, for example C-reactive Protein (CRP) tests to reduce unnecessary antibiotic prescribing and introduced Exhaled Nitric Oxide (FeNO) to maximise asthma management for patients led by the advanced nurse practitioner. Since initiating FeNO early results showed improved symptom control, reduced exacerbations and hospital admissions. Of 203 tests audited, 33 patients had medication reduced, 11 patients had medication stopped, 50 patients had medication increased and 35 reported improvement in their symptoms.
- The practice worked closely with colleagues from adult social care (ASC) to support patients and their carers. We noted at any one time the practice was engaged jointly in coordinating the care of around 50 patients. We were told by the ASC the involvement of the practice was unique and the joint working enabled positive outcomes for patients. We were provided with numerous examples especially in relation to end of life care where joint working was crucial but also examples of enabling patient with dementia to remain at home or where patients in crisis due to mental health accessed swift coordinated response led by the GP.
- The practice initiated a minor injuries service with aim to provide the treatment direct to the presenting patient rather than referring on to the A&E for their management. Data provided by the practice showed of 77 patients treated under the scheme only 5 patients were sent to A&E, 45 were examined and given advice and 20 were sent direct for and x-ray.
- The practice worked closely with The Bureau (Glossop’s Voluntary & Community Network who work to support people to stay physically and socially active, improve mental wellbeing and live independently for longer.) to launch social prescribing (community navigation) as a single point of contact to offer support to patients with their health and social needs. The Bureau, hold a drop in session and booked appointment at the practice weekly. The aim was to reduce repeat attendances and multiple GP appointments where the issues were social. Data provided by the practice showed 23 social referrals have been made by GPs as well as staff promoting the drop in sessions. Evaluation by The Bureau in November 2017 showed Manor House Hadfield were actively engaged in social prescribing and had referred patients for a range of support including mobility, anxiety/depression, loneliness and social isolation.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
23rd April 2015
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Manor House Surgery Hadfield on 23rd April 2015. Overall the practice is rated as good.
Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services for all the population groups.
Our key findings across all the areas we inspected 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.
- 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 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.
- 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 had a very active patient participation group and feedback sought from patients and staff was acted upon.
We saw some areas of outstanding practice :
The practice had a system whereby patients could access their own medical records from their home computers and through their smart phones. Around 100 patients were using this service and the patient participation group were helping to educate patients about the advantages such as managing appointments on line, reviewing blood and test results and direct access to a nurse or doctor with a query without making a telephone call or an appointment.
There was a patient information room at the practice with A-Z health information available in structured folders offering advice and education and encouraging self management of long term conditions and other minor ailments. There were comfortable chairs, access to a computer, a blood pressure monitoring machine and weighing scales.
A member of the patient participation group (PPG), with help and support from the lead GP, had attended training and set up a patient support group to provide talking therapy support for patients waiting a long time for referral to psychology services. The PPG was heavily supported by the GPs and staff at the practice.
We saw an area where the provider needs to make improvements.
The provider should:
- Ensure that all members of staff who carry out chaperoning duties have received a Disclosure and Barring Service (DBS) check.
- Ensure that all staff files have a record of the required documentation to evidence proof of their identity and their employment history.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice