Manor Drive Medical Centre

Updated 12 December 2016

Manor Drive Medical Centre provides primary medical services in Kingston to approximately 12,800 patients and is one of 27 member practices in the NHS Kingston Clinical Commissioning Group (CCG). The practice operates under a General Medical Services (GMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

The practice population is in the tenth least deprived decile, with income deprivation affecting children and adults lower than local and national averages and higher than average life expectancy.

The practice operates from two purpose built premises adjacent to one another which have been converted into one medical centre. There are patient facilities, including treatment and consultation rooms, reception and waiting area, toilet and babychange facilities, accessible facilities, and administrative areas on the ground floor, which is wheelchair accessible throughout. The premises is shared with other services provided by the local CCG.

The practice clinical team consists of three full time GP partners and two full time salaried GPs. The practice provides 42 GP sessions per week. The doctors are supported by one part time advanced nurse practitioner providing nine sessions per week, three part time practice nurses and one part time health care assistant. The non-clinical team consists of thirteen administrative and clerical staff including the practice manager.

Patients can access the practice from 8.45am until 1.00pm and from 2.00pm until 6.00pm on a Monday, Tuesday, Thursday and Friday, and from 8.45am until 5.00pm on a Wednesday. Appointments are available from 9.00am until 11.00am Monday to Friday and from 3.30pm until 6.00pm on a Monday, Tuesday, Thursday and Friday and from 3.00pm until 5.00pm on a Wednesday. Extended hours are available on Monday evenings from 6.00pm until 8.00pm for pre booked appointments. Phone lines are operational between the hours of 8.00am and 1.00pm and 2.00pm and 6.30pm Monday, Tuesday, Thursday and Friday and between 8.00am and 5.00pm on a Wednesday. Between 1.00pm and 2.00pm, and after 5.00pm on a Wednesday, patients phoning the practice are advised via answerphone message to call back after 2.00pm for routine matters, or for urgent matters patients can select the option to be put through to the duty doctor.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8.00am when the practice directs patients to seek assistance from the locally agreed out of hours provider.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of family planning, treatment of disease, disorder or injury, diagnostic and screening procedures, and maternity and midwifery services.

The practice was previously inspected in July 2013 and met the required standards.

Updated 12 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manor Drive Medical Centre on 9 August 2016. 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 an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice, however this was not always clearly recorded.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Performance for diabetes-related indicators was comparable to the local and national average for 2014/15, with some indicators below average; however, the practice demonstrated improvement in these areas for 2015/16.

• 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. Improvements were made to the quality of care as a result of complaints and concerns, however the practice did not keep a log of verbal complaints and comments to identify trends and areas for improvement.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Access to the service, particularly on the telephone, was highlighted as an issue; however, the practice had put in place measures to improve access.
• 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 proactively 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.

The areas where the provider should make improvement are:

• The practice should continue to monitor, evaluate and improve performance in diabetes care.

• The practice should consider how to better record the analysis of significant events, including how learning is recorded and shared.

• The practice should consider a system for recording verbal complaints and feedback in order to identify trends and make improvements to services.

• The practice should continue to monitor, evaluate and improve access to services.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 12 December 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.

• Performance for diabetes-related indicators was comparable to the local and national average for 2014/15, with some indicators below average; however, the practice demonstrated improvement in these areas for 2015/16.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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 12 December 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, for example, children and young people who had a high number of A&E attendances. 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 practice’s uptake for the cervical screening programme was 83%, which was comparable to the CCG average of 83% and the national average of 82%.

• 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 and health visitors.

Updated 12 December 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.

• All older people had a named GP responsible for their care.

Updated 12 December 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 reflects the needs for this age group.

Updated 12 December 2016

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

• Performance for mental health related indicators was comparable to the local and national averages.

• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 may have been experiencing poor mental health.

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

Updated 12 December 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 homeless people, travellers and those with a learning disability.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.