Archived: Ashlea Medical Practice Also known as Gilbert House

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 5 November 2014. Breaches of legal requirements were found during that inspection within the safe domain. After the comprehensive inspection, the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:

• Improve the security for the storage of blank prescription forms and recording the serial numbers of prescription forms in line with national guidance
• Record all significant events and ensure that regular review meetings are documented to demonstrate that the practice had learned from these and that findings are shared with relevant staff

Our previous report also highlighted areas where the practice should improve:-

• Record notes from reception staff meetings
• Ensure all staff complete safeguarding for Vulnerable Adults

We undertook this focused inspection on 14 July 2015 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

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

• Significant events were a standing agenda item in the practice meeting held every three weeks.
• Minutes were kept of the significant events meeting discussions and reflective learning was recorded.
• Blank prescription forms were handled in accordance with national guidance as these were tracked through the practice and kept securely at all times.
• Records were kept of the serial numbers of blank prescriptions pads issued to the GPs and these were counter signed by the GP and the reception manager.
• Prescription pads were stored in a lockable draw in an area where non authorised staff did not have access.
• Most staff had completed training on safeguarding vulnerable adults and dates were in place for those that were yet to take place.
• We saw that minutes were being kept of reception staff meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 March 2015

The practice is rated as good for the population group of patients with long term conditions. When needed longer appointments and home visits were available. All these patients had structured annual reviews to check their health and medicine needs were being met. The practice nurses were trained and experienced in providing diabetes and asthma care to ensure patients with these long term conditions were regularly reviewed and supported to manage their conditions. GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care. Flu vaccinations were routinely offered to patients with long term conditions to help protect them against the virus and associated illness.

Updated 19 March 2015

The practice is rated as good for the population group of families, children and young patients. Appointments were available outside of school hours and the practice was suitable for children and babies. Specific services for this group of patients included family planning clinics, antenatal clinics and childhood immunisations. The practice offered contraceptive implants and coil fitting. We were provided with good examples of joint working with midwives and health visitors. Practice staff had received safeguarding training relevant to their role. Safeguarding policies and procedures were readily available to staff. All staff were aware of safeguarding children and how to respond if they suspected abuse. The practice ensured that children needing urgent appointments would be seen on the day. The practice had links with counselling services for 15 to 25 years olds.

Updated 19 March 2015

The practice is rated as good for the care of older people. Patients over 65 years made up 32% of the practice’s population group which was above the national average. The practice provided services for patients in nursing homes. There were arrangements in place to provide flu and pneumococcal immunisation to this group of patients. Patients were able to speak with or see a GP when needed and the practice was accessible for patients with mobility issues. Clinics included diabetic reviews, blood tests and blood pressure monitoring was available. Multidisciplinary meetings took place monthly to discuss at risk patients and those needing palliative care. There was good communication between the practice and other services including the community matron, social services and support organisations for carers. Community matrons are highly experienced senior nurses who work closely with patients in the community to provide, plan and organise their care. The practice had a safeguarding lead for vulnerable adults. The practice had good relationships with a range of support groups for older people.

Updated 19 March 2015

The practice is rated as good for the population group of working-age people (including those recently retired and students). Patients could book appointments either by telephoning, in person or on line via the practice’s website. This ensured patients were able to book appointments with the practice at times and in ways that were convenient to them. The practice had several late evening and early morning appointments to accommodate those patients that worked. Patients reported that access was mainly good. Patients were able to request a GP to telephone them instead of attending the practice. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group.

Updated 19 March 2015

The practice is rated as good for the population group of people experiencing poor mental health (including patients with dementia). The practice offered a range of services to patients experiencing mental health problems and 90% of patients experiencing poor mental health had received an annual physical health check. Patients could be referred to in–house counselling services if appropriate. The practice had a lead GP for mental health. The practice was aware that data showed they were below average for diagnosing dementia. The practice was investigating this further. A range of leaflets detailing support groups for people with poor mental health were available in the practice.

Updated 19 March 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice supported patients with a learning disability registered with the practice and supported patients who lived at a learning disabilities care home. The practice carried out annual health checks for patients with a learning disability and 98% of these patients had received a health check. The practice offered longer appointments for patients with a learning disability. Patients not registered at the practice could access services and translation services were available for patients who did not use English as a first language. The practice had good access for those with limited mobility or who used wheelchairs. Accessible toilet facilities were available The practice supported patients who registered as a carer. The practice had good links with the local night shelter and supported transient patients to access care. The practice was aware of and advertised other services that could provide support for this population group.