Archived: The Moorings Medical Practice

Updated 13 June 2017

The practice operates 2A Valley Road, Kenley, Surrey, CR8 5DG. The practice is based across two floors of a converted property although all clinical areas are on the ground floor. It is part of the Croydon clinical commissioning group area. Services are delivered under a Personal Medical Services (PMS) contract. (PMS contracts are locally agreed agreements between NHS England and a GP practice).

The practice has approximately 6,000 patients. The surgery is based in an area with a deprivation score of 8 out of 10 (10 being the least deprived). The practice population’s age demographic is generally in line with the national average. However, the number of patients over the age of 80 is slightly higher than the national average. Patients of this age are more likely to have multiple issues of poor health. The practice provides care to six residential homes in the local area with a total of 117 patients.

The GP team includes three partners (one male and two female, 2.5 whole time equivalent [WTE] with a total of 20 clinical sessions). The nursing team includes two nurses (1.00 WTE) and one Healthcare Assistant. The clinical team is supported by a practice manager, a reception manager and nine other administrative or reception staff.

The practice is open from 8.00am to 6:30pm Monday to Friday. There are also extended hours available on Wednesdays and Thursdays from 6:30pm until 7:30pm. The practice offers appointments throughout the day when the practice is open. When the surgery is closed urgent GP services are available via NHS 111.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services, family planning and treatment of disease, disorder or injury.

The practice was inspected by CQC on 20 December 2016.

Updated 13 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Moorings Medical Practice on 20 December 2016. The overall rating for the practice was good, although the safe domain was rated as requires improvement. The inspection found the practice must undertake the following:

• The practice must ensure that clinical rooms in the practice are secure.

• The practice must ensure that all electrical equipment in the practice has been portable appliance tested.

• The practice must ensure that a defibrillator is available on the premises or that they carry out a risk assessment to mitigate the risks of not having one.

The report also found that the practice should do the following:

• The practice should consider requiring staff to undertake basic life support training on an annual basis.

The full comprehensive report of the 20 December 2016 inspection can be found by selecting the ‘all reports’ link The Moorings Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 11 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 20 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 as good.

Our key findings were as follows:

• The practice had added locks to all rooms at the practice such that they were secure.

• The practice had ensured that the practice had all required equipment and that it had all been checked to ensure that it was working correctly.

• The practice had arranged training for all staff to attend basic life support training.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 15 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.

• Performance for diabetes related indicators was similar to the national average. The practice had scored 90% for diabetes related indicators in the last QOF similar to the national average of 89%. The exception reporting rate for diabetes related indicators was 9.6%, lower than the national average of 11.6%.

• 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 15 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.

• 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.

• The practice’s uptake for the cervical screening programme was 84%, which was better than the CCG average of 72% and comparable to the national average of 82%. There was a policy to offer telephone reminders for patients who did not attend for their cervical screening test.

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

• The practice sent first and fourth birthday cards to all children to remind them and their carers about the immunisations needed.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 15 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.

• All patients over the age of 75 had a named GP.

• The practice provided care to six residential and nursing homes.The care homes were satisfied with the care provided.

Updated 15 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 as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice had extended hours until 7:30pm twice a week for the benefit of working patients.

Updated 15 February 2017

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

• 89% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average. The practice has higher prevalence of patients with dementia than any other practice in Croydon CCG.

• QOF performance for mental health related indicators was similar to the national average. The practice had scored 97% for mental health related indicators in the last QOF, which was similar to the national average of 93%. The exception reporting rate for mental health related indicators was 11%, similar to the national average of 12%.

• 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 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.

Updated 15 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 homeless people, travellers and those with a learning disability.

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

• The practice looked after two care homes for patients with learning disability and had arranged for influenza vaccines to be provided on a Saturday morning so patients could attend together and not miss their weekday activities.

• 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.

• 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.