Archived: Dr KV Reddy Also known as Dr.K.V.Reddy & Dr Chandra Siripurapu

Updated 27 August 2015

Dr KV Reddy (Deneside Medical Centre) provides general medical services (GMS) to approximately 4,700 patients in the catchment area of Seaham and surrounding villages, which is the Durham Dales, Easington and Sedgefield Clinical Commissioning Group (CCG) area.

There are two GP partners, both male. There is a team of two nurse practitioners, one practice nurse and two healthcare assistants. They are supported by a team of management, reception and administrative staff.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; surgical procedures; family planning; maternity and midwifery services; and treatment of disease, disorder and injury. The practice has higher levels of deprivation compared to the England average. There are higher levels of people aged 65 and above, and more people with a long term health condition, or claiming disability living allowance than the England average.

The practice has opted out of providing Out of Hours services, which patients access through the 111 service. The practice is a member of the South Durham Health CIC Federation.

Updated 27 August 2015

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 17 June 2015.

Overall, we rated this practice as good.

Specifically, we found the practice to require improvement for providing safe services. The practice was good for providing effective, caring and responsive services, and for being well led.

Our key findings were as follows:

• Staff generally understood the process to report incidents, and there was some evidence of learning and discussion around incidents. However not all incidents were fully recorded, and learning was not shared widely. Staff awareness of incidents varied, and we could not always verify whether actions had been taken as a result of an incident.
• Risk assessments relating to the safe running of the practice were not always monitored and reviewed.
• The practice provided a good standard of care, led by current best practice guidelines. Care and outcomes for patients was not always audited fully.
• Patients told us they were treated with dignity and respect.
• Patients could access generally appointments without difficulty, and were happy with the telephone and repeat prescribing systems.
• The building had sufficient facilities and equipment to provide effective services.
• The practice had some strategy and objectives for the future, however staff awareness of these varied.

We saw some areas of outstanding practice including:

• Once a month the practice held awareness days for carers to enable them to keep up-to-date with help and advice. The practice worked with a local carer support organisation who held open days within the practice on a quarterly basis.
• The practice had a buddy system to allow patients who may struggle to access some areas of the service to have one point of contact with a named member of staff, who would assist them with tasks such as making an appointment or ordering medication.

However, there were also areas of practice where the provider needs to make improvements.

Importantly the provider must:

• Ensure systems are in place to assess, monitor and mitigate the risks to patients, staff and visitors to the practice.

The provider should:

• Ensure that ‘patients at risk’ registers are regularly reviewed and updated.

• Ensure that learning from incident and complaints is fully recorded and cascaded to maximise learning opportunities.

• Ensure that formal governance arrangements are sufficient to fully assess and monitor risks and the quality of the service provision.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 August 2015

The practice is rated as good for the care of people with long-term conditions. People with long term conditions were monitored and discussed at multi-disciplinary clinical meetings so the practice was able to respond to their changing needs. Information was made available to out of hours providers for those on end of life care to ensure appropriate care and support was offered. People with conditions such as diabetes and asthma attended regular nurse clinics to ensure their conditions were monitored, and were involved in making decisions about their care. Attempts were made to contact non-attenders to ensure they had required routine health checks.

Updated 27 August 2015

The practice is rated as good for the care of families, children and young people. Systems were in place to identify children who may be at risk. For instance, the practice monitored levels of children’s vaccinations and attendances at A&E. However the practice did not actively monitor and review which patients were on this list, and the safeguarding lead was unaware of how many children were classified as at risk and when this was last reviewed. Immunisation rates were above average for all standard childhood immunisations. Full post natal and 6 week baby checks were carried out by GPs, and weekly baby clinics were available at the practice premises.

Updated 27 August 2015

The practice is rated as good for the care of older people. The over 75’s had a named GP. The practice carried out dementia screening and memory loss clinics, and worked with an attached Community Psychiatric Nurse (CPN) who worked in clinics alongside the practice. Home visits including to nursing and care homes were carried out by community staff attached to the practice as part of a CCG wide initiative, as well as by the practice’s advanced nurse practitioner. The practice held multi-disciplinary meetings to discuss those with chronic conditions or approaching end of life care. Care plans had been produced for those patients deemed at most risk of an unplanned admission to hospital. Information was shared with other services, such as out of hours services and district nurses. Patients with conditions such as dementia, and their families were signposted to local voluntary organisations. Nationally reported data such as the Quality and Outcomes Framework (QOF) showed the practice had outcomes comparable to the average for conditions commonly found in older people.

Updated 27 August 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of the working population had been identified, and services adjusted and reviewed accordingly. Routine appointments could be booked in advance, or made online. Repeat prescriptions could be ordered online. Evening appointments were available on Mondays until 8:30 pm to help those who could not access the surgery during core hours. The practice provided NHS health checks for this group including diet and nutrition advice.

Updated 27 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Nationally reviewed data showed the practice carried out additional health checks and monitoring for those experiencing a mental health problem. The practice made referrals to other local mental health services as required. The practice was assigned those patients who had been removed from other practice lists due to violent or aggressive behaviour, and staff had been given extra conflict resolution training as they aimed to provide a full service to these patients. The practice worked with the mental health team and local drug and alcohol service who attended at the practice one day a week and also gave advice about benefits and employment.

Updated 27 August 2015

The practice is rated as good for the care of people living in vulnerable circumstances. The practice had a register of those who may be vulnerable, including those with learning disabilities, who were offered annual health checks. Patients or their carers were able to request longer or home appointments if needed. The practice had a register for looked after or otherwise vulnerable children. However these registers were not regularly monitored and reviewed, and GPs were unaware how many patients were on them. There was no regular programme of safeguarding meetings, although the practice did communicate with the health visitor on an ad hoc basis as required .The computerised patient plans were used to flag up issues where a patient may be vulnerable or require extra support, for instance if they were a carer. The practice hosted carers awareness days once a month and worked with a local carer support organisation. All carers and nursing homes had been invited to join the Patient Participation Group (PPG).

Patients were able to access a named member of staff to support them in accessing services such as help with booking appointments or repeat prescriptions. There was some mixed awareness amongst staff around their responsibilities in reporting and documenting safeguarding concerns, and who the safeguarding lead for the practice was.