Devaney Medical Centre - JW Bates

Updated 25 February 2016

Devaney Medical Centre is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post natal care. The practice is based in Oxton, Wirral close to Birkenhead town centre. The practice is situated in an area of high deprivation.

The practice has a General Medical Services (GMS) contract with a registered list size of 8139 patients (at the time of inspection). The practice has five GP partners. They are a training practice for trainee GPs. The practice also has two practice nurses, a practice manager and a number of administration and reception staff.

The practice is open between 8am to 6.30pm Monday to Friday with appointments bookable in a variety of ways. Extended access is available from 8am to 12pm on Saturdays. Home visits and telephone consultations are available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients received urgent medical assistance when the practice was closed. Out of hours patients are asked to contact the NHS 111 service to obtain healthcare advice or treatment.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Devaney Medical Centre on 17 December 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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 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 sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour. (This means that providers must be open and transparent with service users about their care and treatment, including when it goes wrong.)

There were some elements of outstanding practice including:

• The practice hosted a dementia clinic led by a consultant geriatrician to support patients with dementia to receive support and treatment in a familiar and convenient location.

The areas where the provider should make improvement are:

• Ensure that a policy and protocol is put in place to reflect how significant events are to be managed.

• Review the safeguarding children protocols to ensure that information about vulnerable children attending A&E departments or other healthcare walk in centres is appropriately coded to support effective monitoring of their health and wellbeing.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 25 February 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 90% compared to the national average of 88%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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 25 February 2016

The practice is rated as good 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 relatively 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.

• The CQC data pack showed that screening rates of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 77% compared to the national average of 81%

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 25 February 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 25 February 2016

The practice is rated as good 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 reflected the needs for this age group.

Updated 25 February 2016

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

• 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2013 to 31/03/2014) compared with the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they had been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 25 February 2016

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.

• The practice offered longer appointments for patients with a learning disability.

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

• The practice informed 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.