Bee Fold Medical Centre

We carried out an announced comprehensive inspection at Bee Fold Medical Centre on 1 August 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as outstanding overall.

We rated the practice as outstanding for providing caring services because:

• The practice adopted a holistic approach to caring by addressing all the needs of the patient, including their physical, mental, and emotional health, while taking social factors into consideration.
• Feedback from patients was consistently positive. There were 38 CQC comment cards completed (2% of the patient population) and all had very positive comments about how caring the staff were and they were always treated with dignity and respect.
• The results from the National Patient Survey were consistently high and in most questions were higher than the CCG and national averages.
• There was a strong person-centred culture.
• Patients were truly respected and valued as individuals and were empowered as partners in their care.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as outstanding for providing responsive services because:

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The practice had open access appointments available for the patient population on certain days when the surgery was open. This meant they could attend at a day and time of their choice and they were given a consultation with the GP.
• The practice introduced an initiative to support parents, guardians and expectant parents. This was to provide professional advice and to empower them to deal with minor ailments and emergency situations.
• The practice supported military veterans and actively ensured that all current veterans were signposted to the appropriate service and were offered a referral to the improving access to the psychological therapies (IAPT) service if appropriate.

We rated the practice as outstanding for providing well led services because:

• The practice management team were motivating, forward thinking, organised and innovative with a sensible approach and clear goals. Staff told us they received excellent support and encouragement from the SSP leadership team to do this. The practice management team were compassionate and caring. Quality and integrity were a high priority resulting in a caring culture within a strong practice. There were opportunities provided for all staff for their personal development.
• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• There was strong collaboration across all staff and a common focus on engaging with patients and other services to improve quality of care and the patient experience.
• The practice embraced social prescribing for the community to ensure patients received timely intervention when they needed it most, signposted them to services that could help them and ensured support was offered locally so the patient population could easily attend appointments.

We have rated this practice as good for providing safe and effective because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.

We saw several areas of outstanding practice including:

• Practice champions who were members of the administrative team, for example palliative care and carers’ champions, were trained to safeguarding vulnerable adults and children level three. This enabled champions to have a better understanding of the needs and vulnerabilities of some patients. They were familiar with these patients and trained to recognise any concerns. For example, the cancer champion contacted all newly diagnosed patients to ensure the patient had the systems, processes and support in place for their follow up treatment and medication.
• The practice engaged with the “red box project”. This is a community-based, not-for-profit initiative, which aims to support young people throughout their periods by providing free period products. The practice collected feminine hygiene products and made them available for patients in the surgery. This was a discreet service for those patients who could not afford these products. There were posters in the waiting area and in the toilets to raise patient awareness of this.
• The practice was a breast-feeding friendly site. They worked with a local charitable organisation to fully understand the barriers associated with breast-feeding and identified a private space in the practice for this. They received accreditation for this and there was information displayed in the practice to inform patients of this facility.
• The practice had implemented a “Good Wish Tree” as a way to promote positive mental health. The aim of this was to provide encouragement to immediately improve a person’s mood and spirits and to boost a person’s self-esteem and make them smile. The practice encouraged staff and patients to support this by taking one of these positive quotes and messages from the “Good Wish Tree” to improve their own and someone else’s day. Staff we spoke with informed us that several patients had commented on how they felt this had a positive impact on their well-being.
• The practice in partnership with its PPG held a dementia awareness training event with the Good Deeds Trust. As part of their work the Good Deeds Trust aimed to prevent and relieve sickness, and advance and preserve health, in particular people for people with Alzheimer’s disease and dementia. We received positive feedback from the PPG and staff about the training and that it had raised their awareness of the needs of this population group.
• The practice sent members of their team on the AWARM (Affordable Warmth Access Referral Mechanism) course to help them to identify patients that may be at risk of fuel poverty. They kept a stock of the AWARM kits in surgery so that clinicians or staff on identifying patients that may fall in to this category can give out an AWARM kits. They were provided with 10 kits and all 10 were given out to patients who they felt were at risk of fuel poverty. Staff were trained to identify patients at risk and how to refer into the AWARM service.
• The practice supported military veterans and had eight registered with the practice. The practice actively ensured that all current veterans were signposted to the appropriate service and were offered a referral to the improving access to the psychological therapies (IAPT) service if appropriate. The military veterans’ service provided through Pennine Care NHS Foundation Trust attended the practice weekly to see any patient that needed support from them. The practice had a good working relationship with this service. We spoke with the lead from the service who told us they felt the practice was a safe and caring environment for these patients. They also had a dedicated noticeboard in the waiting area and a practice military veterans champion who maintained the register. The practice had also registered to become an “Armed Forces Military Veteran Accredited Practice”.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care