Archived: Central Hove Surgery

Updated 12 August 2016

Letter from the Chief Inspector of General Practice

The practice was rated good overall and is now rated good for providing safe services.

We carried out an announced comprehensive inspection of this practice on 22 March 2016. Breaches of legal requirements were found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 14 July 2016 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.

During our previous inspection on 22 March 2016 we found the following areas where the practice must improve:-

• Put arrangements in place to ensure the safe use of medicines.

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

• Undertake a formal, written risk assessment regarding the decision not to have a defibrillator on the practice premises.

• Develop an ongoing audit programme that demonstrates continuous improvements to patient care in a range of clinical areas. Ensure there are at least two cycles of a clinical audit.

• Ensure that higher levels of exception reporting for the quality and outcomes framework are kept under review.

• Hold regular meetings with the patient reference group and ensure feedback is sought on practice specific issues.

• Undertake pre-employment health checks for all new staff.

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

During this inspection we found:

• The practice had invested in new vaccine fridges and there was an updated cold chain policy which was adhered to.

• The practice had updated their prescription security protocol to include the security of prescriptions. There was a register of prescription ordering and distribution which included serial numbers of prescriptions issued.

We also found in relation to the areas where the practice should improve:

• The practice had taken the decision to have a defibrillator on the practice premises and this was in place.

• The practice had an active audit culture in place and had conducted a two cycle audit since our initial inspection.

• The practice provided us with minutes of meetings during which discussion relating to reducing exception reporting had taken place.

• The practice had introduced a protocol of undertaking pre-employment health checks for all new staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 May 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 scores for all the diabetes indicators in the quality outcomes framework were higher than the national average. For example, 91% of patients on the diabetes register, had a record of a foot examination and risk classification within the preceding 12 months compared to a national average of 88%.

• Longer appointments and home visits were available when needed.

• All patients with long tem conditions had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 13 May 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.

• 77% of patients with asthma, on the practice register, had had an asthma review in the preceding 12 months

• 76% of women aged 25-64 had notes recording that a cervical screening test had been performed in the preceding 5 years (04/2014 to 03/2015) compared to the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked closely with midwives, health visitors and school nurses. Midwifery services were available at the practice one afternoon a week.

• Baby changing facilities were available.

Updated 13 May 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.

Updated 13 May 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 13 May 2016

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

• 85% patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (04/2014 to 03/2015) which was comparable to the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice made referrals to a locally commissioned service which provided specialist psychiatric nursing support aimed to improve the independence and recovery of patients with serious mental illness.

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

Updated 13 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice had identified patients living in vulnerable circumstances including homeless people, and those with a learning disability.

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

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.