Archived: Dr Maria Mercedes Malpica Gontad Also known as Dallam Lane Medical Centre

Updated 18 February 2016

Dr Maria Mercedes Malpica Gontad, also known as Dallam Lane Medical Centre, is located in Warrington, Cheshire. The practice provides a service to approximately 2980 patients. The practice is situated in an area with higher than average levels of deprivation when compared to other practices nationally. The percentage of patients with long standing health conditions is higher than average when compared to other practices nationally. The percentage of patients with health related problems in daily life and caring responsibilities is similar to national averages.

The practice is run by one GP and there is an additional salaried GP (1 male and 1 female). There is one practice nurse, one part time health care assistant, a practice manager, reception and administration staff.

The practice is open from 8.00am to 6.30pm Monday to Friday. The practice had signed up to providing longer surgery hours as part of the Government agenda to encourage greater patient access to GP services. As a result patients could access a GP at another surgery from 6.30pm until 8.00pm Monday to Friday and between 8.00am to 8.00pm Saturday and Sunday. Outside of practice hours patients could access the Bridgewater Trust for primary medical services.

The practice has a General Medical Services (GMS) contract and offered a range of enhanced services for example; childhood vaccination and immunisation,  influenza and pneumococcal immunisations, facilitating early diagnosis and support to patients with dementia and avoiding unplanned hospital admissions.

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Maria Mercedes Malpica Gontad on 16 December 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff assessed patient’s needs and delivered care in line with current evidence based guidance.

• Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff were supported in their roles and were kept up to date with training and professional development.

• Staff were aware of procedures for safeguarding patients from the risk of abuse.

• Systems were in place to deal with emergencies and all staff were trained in basic life support.

• There were systems in place to reduce risks to patient safety. For example equipment checks and fire safety practices.

• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

• Recent improvements to the appointments system meant that patients found it easy to make an appointment with a named GP and there was good continuity of care.

• The practice provided a range of enhanced services to meet the needs of the local population and they planned to increase these.

• There was a clear leadership and structure and staff understood their roles and responsibilities.

• Complaints were investigated and responded to appropriately.

Areas where the provider should make improvements:

• Review clinical staffing, in particular nursing, to ensure that this is sufficient to meet the needs of patients.

• Implement a more effective system to record/demonstrate the actions taken in response to significant events. This should include clearly documenting: the process of investigation, the conclusions reached and actions taken including the reporting of events for wider learning.

• Demonstrate attempted improvements to patient carethrough the completion of two cycle clinical audits.

• Review the equipment in place to support patients who are physically disabled.

• Review the arrangement of the reception and waiting area to ensure patients’ privacy and confidentiality is protected.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 2016

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these. The practice nurse  had the lead role in chronic (long term) disease management. Patients with long term conditions were invited to attend reviews to check that their health and medication needs were being met. Patients were sent follow up letters to attend for health checks if they failed to attend their original appointment. Data showed that the practice was comparable with other practices for the care and treatment of people with chronic health conditions such as diabetes. Longer appointments and home visits were available when needed. The GPs attended regular multi-disciplinary  meetings  to discuss patients with complex needs. The practice worked to avoid unplanned hospital admissions for  patients  and patients were contacted after leaving hospital to ensure their treatment was effectively co-ordinated.

Updated 18 February 2016

The practice is rated as good for the care of families, children and young people. There were systems in place to identify children who were at risk. Regular meetings were held  with health visitors to share information or concerns about child welfare. Appointments were available outside of school hours and appointments were provided to children at short notice. The premises were suitable for children and babies and baby changing facilities were provided. Immunisation rates were comparable with local CCG benchmarking for standard childhood immunisations. Immunisations could be provided without a pre-booked appointment to encourage uptake. The practice monitored any non-attendance of babies and children at vaccination clinics and reported any concerns  identified. The staff we spoke with had appropriate knowledge about child protection and they had access to policies and procedures for safeguarding. A dedicated notice board provided information about child health and signposted people to support agencies offering advice and support to children and families. The practice offered appointments with an advanced paediatric nurse practitioner who had specialist training and experience in the diagnosis, care and treatment of ill children. This was as part of a locally agreed pilot with the CCG.  The pilot also included the services of a family nurse practitioner who supports families with health needs. 

Updated 18 February 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice kept up to date registers of patients with a range of health conditions and used this information to plan reviews of health care and to offer services such as regular health checks.  Home visits and urgent appointments were provided for those patients with enhanced needs. The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care. GPs attended multi-disciplinary meetings  to review the care and treatment provided to people living in residential care homes and to prevent unplanned hospital admissions.

Updated 18 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice offered  an online repeat prescription request service and appointment booking service which provided flexibility to working patients and those in full time education. The use of an electronic prescription service enabled patients to collect medication in the most convenient location. Late appointments and weekend appointments were available. Telephone consultations were also available. A range of health promotion and screening that reflected the needs for this age group was available to patients and routine health checks were provided to this age group.

Updated 18 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Data about how people with mental health needs were supported showed that outcomes for patients using this practice were comparable when compared to local and national data. Staff were knowledgeable about obtaining consent and supporting patients who lacked capacity. Patients experiencing poor mental health were provided with information about how to access support groups and voluntary organisations. The practice took part in an enhanced service for dementia screening  to identify patients at risk of dementia and to develop care plans with them. A counselling service was available to patients on a regular basis.

Updated 18 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. 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. The practice held a register of patients living in vulnerable circumstances. Information about how to access a range of support groups and voluntary organisations was available in the waiting area. Interpreter services were available for patients who required this. The practice had good links with a local drug abuse service.