Deepcar Medical Centre

Updated 31 May 2017

Deepcar Medical Centre is located in a purpose built health centre in Deepcar, Sheffield and accepts patients from Deepcar, the surrounding semi-rural area and several small rural outlying villages. Public Health England data shows the practice population is similar to others in the Clinical Commissioning Group (CCG) area with a slightly higher than average number of patients aged over 45 years old compared to the England average. The practice catchment area has been identified as one of the seventh least deprived areas nationally.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 5,160 patients in the NHS Sheffield CCG area. It also offers a range of enhanced services such as anticoagulation monitoring and childhood vaccination and immunisations.

Deepcar Medical Centre has four GP partners (one female, three male), one female salaried GP, T two practice nurses, one health care assistant, a practice manager and an experienced team of reception and administration staff. The practice is a teaching practice for foundation year medical students.

The practice is open 8.30am to 6.30pm Monday to Friday. Extended hours are offered 9.30am to 11.30am on Saturday mornings. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoons when there are no appointments.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed during the hours of 8am and 6.30pm. For example, at lunchtime between 1pm and 2pm. Patients are informed of this when they telephone the practice number.

Updated 31 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Deepcar Medical centre on 14 December 2016. The overall rating for the practice was good with requires improvement in safe. The full comprehensive report from 14 December 2016 can be found by selecting the ‘all reports’ link for Deepcar Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 14 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated good. Specifically, following the focused inspection we found the practice to be rated good for providing safe services.

Our key findings were as follows:

• The practice had implemented standard operating procedures for staff to follow in the dispensary to ensure all prescriptions were signed by a GP prior to medication being dispensed.
• Standard operating procedures in the dispensary had been reviewed and updated to include monitoring of uncollected dispensed medication.
• The practice had implemented a system to monitor and track blank prescriptions on receipt into the practice in accordance with NHS Protect Security of Prescriptions Guidance 2013.
• The practice had introduced a system of ‘near miss’ recording in the dispensary to identify trends and patterns in errors and to take action to prevent reoccurrence.
• The practice maintained a complete record of the immunity status of clinical staff as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 1 February 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.
• 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.

Updated 1 February 2017

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 accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Data showed 96% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 81%.
• 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 practice held bi-monthly safeguarding meetings with health visitors, midwives and school nurses at the practice.

Updated 1 February 2017

The practice is rated as good for the care of older people. .

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice provided medical care and weekly routine GP visits to patients who resided in a local care home.
• The practice worked closely and actively referred patients to Sheffield Age UK to help patients retain and regain their independence and offer support and advice services. A representative from Age UK attended regular meetings at the practice.

Updated 1 February 2017

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 offered appointments on a Saturday morning at the practice and weekend and evening appointments at a local practice through the Sheffield satellite clinical scheme.
• 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 1 February 2017

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

• Of those patients diagnosed with dementia, 83% had received a face to face review of their care in the last 12 months, which is comparable to the national average of 84%.
• Of those patients diagnosed with a mental health condition, 94% had a comprehensive care plan reviewed in the last 12 months, which is higher than the national average of 88%.
• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had advised patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 31 May 2017

As the practice is now rated as good for safe services    the overall rating  for the care of people whose circumstances may make them vulnerable is now rated as outstanding . Our findings from the inspection on 14 December 2016 were as follows:

• The practice had worked proactively with other social care providers by identifying patients who required extra social support and had referred to other agencies on the patient’s behalf. For example, Age UK, the local social café and the Sheffield Drinkwell Agewell support group. The practice also hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities. The staff we spoke with proactively referred patients to this service and told us of specific instances where they had referred patients who had approached them directly for help. For example, the receptionist had referred a patient with no access to food and who was going to be made homeless to the community support worker who was able to assist with food vouchers and accommodation.

• The practice had hosted in recent months two coffee mornings at the practice which had been well attended by patients, carers and members of the patient participation group to support local charities. They had used these events to specifically invite patients who were carers and patients who may be vulnerable or isolated. Practice staff baked cakes and provided snacks for the events. Entertainment was also provided through quizzes, bingo and raffles. Support services including representatives from charities and the community support worker were invited to attend to provide advice and signposting to services. For example, the local social café held at the local church. The practice manager told us they received very positive feedback from patients and carers on how it had supported them to engage with others in similar situations and also to find out about support groups and what is happening in the local community.