Background to this inspection
Updated
3 February 2017
The Croft Medical Centre is a GP practice, which provides primary medical services to approximately 8,644 patients predominately living in the Oadby area. All patient facilities are accessible. East Leicestershire and Rutland Clinical Commissioning Group (EL&RCCG) commission the practice’s services.
The practice has six GP partners (four male and two female), one salaried GP (female), two GP registrars (male) and three trainee doctors (female). The nursing team consists of a practice nurse and two health care assistants. They are supported by a Practice Manager, Associate Practice Manager and a team of reception staff and administrative staff.
The practice is open between 8am and 6.30pm Monday to Friday, however closed between 12.30noon and 1.30pm daily. Extended hours appointments are offered between 7.30am and 8am Monday to Thursday. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments and telephone consultations are also available for people that need them.
Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest urgent care centres, as well as accident and emergency departments.
The practice is an approved training practice for the training of General Practice Registrars and medical students. The practice also participated in and is research accredited.
Updated
3 February 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Croft Medical Centre on 13 October 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
-
There was an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.
-
There was a clear process to receive and review safety alerts
-
The practice had two safeguarding leads to ensure there was consistent cover in the event of an absence. Staff demonstrated they understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.
-
The practice used templates specific to the patient record system to ensure treatment and care was in line with best practice, for example diabetes.
-
The practice had a structured approach to clinical audits to demonstrate quality improvement.
-
The practice proactively reviewed patient care plans, including for those identified as high risk of admission to hospital. Any discharges from hospital were reviewed on a daily basis and care plans were amended as appropriate.
-
The practice identified patients who may be in need of extra support and signposted them to the relevant service.
-
Patients said they felt the practice offered an excellent service and felt welcomed by all staff. They also told us they felt listened to and supported by staff who also gave advice on how to self manage their conditions.
-
We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
-
The practice identified carers and provided appropriate support and guidance.
-
Data from the national GP patient survey showed patients rated the practice lower than others with regards to access to the practice. However, the practice had recognised this and took action to improve access.
-
Members of the patient participation group told us the practice had made changes to the appointment system to improve the access to the practice by telephone.
-
There were robust arrangements for identifying, recording and managing risks, issues and implementing mitigating actions.
-
The practice held various monthly meetings to ensure governance issues were discussed and actions were taken as necessary, for example discussion of significant events, complaints, audits and safety alerts.
-
There was a strong focus on continuous learning and improvement at all levels and the practice had been nominated in 2015 and 2016 for GP Awards.
The areas where the provider should make improvement are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
3 February 2017
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.
-
80% of those diagnosed with diabetes had a blood test to assess diabetes control (looking at how blood sugar levels have been averaging over recent weeks) compared to the national average of 78%.
-
Longer appointments and home visits were available when needed.
-
All these patients had a named GP and were offered 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 and personalised care plans were implemented.
-
The practice was involved in a pilot to improve pain management for patients over 65 with long term conditions.
Families, children and young people
Updated
3 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 A&E attendances.
-
Immunisation rates were relatively high for all standard childhood immunisations.
-
The practice’s uptake for the cervical screening programme was 78%, which was comparable to the CCG average of 78% and the national average of 74%.
-
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.
Updated
3 February 2017
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 were able to refer patients to an Integrated Care Facilitator employed by the local council to ensure support was provided holistically.
Working age people (including those recently retired and students)
Updated
3 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 was proactive in offering online services, including bookin appointments and requesting repeat prescriptions.
-
A full range of health promotion and screening was offered that reflected the needs for this age group.
- The practice hosted a physiotherapy service and ultrasound service which had shown a reduction in the number of referrals to secondary care.
- A walk-in blood clinic was available on a daily basis between 8am and 9.45am. Patients were also able to book an appointment for a blood test.
People experiencing poor mental health (including people with dementia)
Updated
3 February 2017
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
-
97% of those with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, compared to the national average of 89%.
-
85% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, compared to the national average of 84%.
-
The practice regularly worked with multi-disciplinary 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 told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
-
The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
-
Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
3 February 2017
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 travellers and those with a learning disability.
-
The practice offered longer appointments for patients with a learning disability and an annual health check.
-
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 various support groups and voluntary organisations.
-
The practice had two safeguarding leads and staff were knowledgeable about their roles and responsibilities if they had concerns about a patient.