Archived: Silverdale Medical Centre

Updated 7 December 2016

Silverdale Medical Centre is situated in Thurmaston, a village north west of Leicester. There is a local population of approximately 10,000 which is likely to increase up to 15,000 as new homes are built over the next five years. Thurmaston is an area with moderate levels of social deprivation alongside private housing. The practice has 4,646 patients.

The practice is located in a converted and extended house which has become increasingly unsuitable for modern general practice. The practice is about to undertake extensive building work to improve and expand facilities for patients and staff.

The practice has three GP partners, one female and two male, a practice nurse and a health care assistant who are both female. There is also a practice manager and other support staff.

The practice is open between 8am and 6.30pm Monday to Friday. The latest appointment is at 5.50pm. Extended hours appointments are offered from 7.30am on four days each week. The service closes between 1.00pm and 2.00pm when patients are provided with a number to call for emergencies.

Out of hours services are provided by DHU (Derbyshire Health United).

Updated 7 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Silverdale Medical Centre on 13 July 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.
• 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.
• 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.
• Patients appreciated being able to make appointments on the same day or pre-booking appointments with a preferred GP
• Urgent appointments were made available for vulnerable patients and unwell children even where the sessions were fully booked.
• The practice had adequate facilities and equipment. It was planning to extend the premises to improve the facilities available.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 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.

• The practice's performance for diabetes management was similar to or slightly higher than national averages, for example 96% of diabetic patients had had a recent foot examination compared to the national average of 90%.

• 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.

• The practice had devised a long-term conditions leaflet that it gave to patients to help advise them on what they might be able to do to help with their conditions.

Updated 7 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.

• Data showed 84% of eligible women had received a cervical screening test compared with the national average of 83%.

• 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. The GP who was the practice’s safeguarding lead met on a regular basis with health visitors to discuss any concerns.

Updated 7 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.

• The practice had identified those older patients at risk of hospital admission and had developed care plans and special notes on their records for out of hours services to avoid unnecessary or inappropriate hospital admissions.

• GPs visited housebound patients at home to provide immunisations and vaccinations such as for flu and shingles.

• Patients aged over 75 had a named GP.

Updated 7 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 reflected the needs for this age group.

• On four mornings a week pre-bookable appointments were available from 7.30am to 8.00am specifically for working patients.

• Pre-bookable telephone consultations were available.

Updated 7 December 2016

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

• 90% of patients living with dementia had a face-to-face care review in the previous 12 months, compared with the national average of 86%.
• 95% of patients with severe mental health problems had a comprehensive agreed care plan documented in their records compared with the national average of 94%.

• 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, and where appropriate their carers, about how to access support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended A&E where they may have been experiencing poor mental health.

• The practice had used its analysis of significant events and identified when some patients were likely to experience a mental health crisis and contacted the patient to offer support.

• Staff had a good understanding of how to support patients with mental health needs and dementia. For example, they were routinely offered longer appointments.

Updated 7 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, carers, people with a learning disability and those with alcohol or substance misuse problems.

• The practice offered longer appointments for patients with a learning disability and staff were often aware of an individual patient’s needs and preferences.

• 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 support groups and voluntary organisations.

• People who were homeless were offered immediate access to care as a temporary patient and also given information about services which could help them.

• The practice had identified that 74 or 1.7% of its patients had caring responsibilities and offered health checks and information about local support services. There was also information available in the waiting area.

• 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.