Hastings House

Updated 29 October 2015

Hastings House Medical Centre is one of 36 member GP practices of South Warwickshire Clinical Commissioning Group. It provides primary medical care service to approximately 10,500 patients in a mainly rural area. The service is provided at Hastings House in Wellesbourne and at the Little Thatch branch surgery in Kineton. Patients may be seen at either location. The practice has a General Medical Services (GMS) contract with NHS England. Hastings House Medical Centre is a dispensing practice and patients that live more than a mile from a pharmacy may have prescriptions dispensed from the practice dispensary. There is also a dispensary at the branch surgery.

Since our previous inspection on 15 May 2014, the practice had formed plans to move to a new purpose built facility within the local area in 2016. We were shown that land had been acquired for the new practice, plans approved and we were shown building work was due to start in June 2015.

The practice offers a range of NHS services including an antenatal clinic run by a community midwife, post-natal appointments, smoking cessation and minor surgery. The practice also cares for patients within six local care homes, this includes patients with dementia and learning disabilities.

The practice has eight GP partners (a mix of male and female), two salaried GPs, two trainee GPs and six practice nurses (three are nurse prescribers, so are able to issue prescriptions). The clinical team are supported by a practice manager, an assistant practice manager, the dispensary manager and team, along with administrative and reception staff. The practice also regularly hosts medical students from the University of Warwick.

Data we reviewed showed that the practice was achieving results that were average or in some areas slightly below average with the South Warwickshire Clinical Commissioning Group in most areas.

The practice does not provide out of hours services to their own patients. Patients are provided with information about local out of hours services which they can access by using the NHS 111 phone number.

The Care Quality Commission had previously inspected the practice on 15 May 2014. The practice was required to take action in a number of areas. There were concerns the practice was not discussing and learning from complaints; not monitoring checks on emergency medicines; did not carry out full checks when recruiting staff; not always completing full clinical audit cycles and not promoting on-line appointment booking.

Updated 29 October 2015

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Hastings House Medical Centre on 14 April 2015. Overall the practice is rated as Good. Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• The practice had comprehensive systems for monitoring and maintaining the safety of the practice and the care and treatment they provided to their patients.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice was proactive in helping people with long term conditions to manage their health and had arrangements in place to make sure their health was monitored regularly.
• The practice was clean and hygienic and had arrangements for reducing the risks from healthcare associated infections.
• The practice had a well-established and well trained team who had expertise and experience in a wide range of health conditions.
• Patients felt that they were treated with dignity and respect. They felt that their GP listened to them and treated them as individuals.
• The practice was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 October 2015

This practice is rated as good for the care of patients with long term conditions, for example asthma, arthritis and diabetes. The practice had effective arrangements for making sure that patients with long term conditions were invited to the practice for annual reviews of their health. Care plans were in place for the most vulnerable patients. Clinics were held for a range of long term conditions, including diabetes, arthritis and chronic obstructive pulmonary disease (COPD) which is a lung disease. Members of the GP and prescribing practice nurses (who could issue prescriptions) ran these clinics. Patients whose health prevented them from being able to attend the surgery received the same service from one of the practice nurses as home visits were arranged. Patients told us they were seen regularly to help them manage their health. When patients with long-term conditions required routine medical appointments, the practice tried to allocate appointments to a regular GP on each occasion.

Updated 29 October 2015

This practice is rated as good for the care of families, children and young people. The practice held weekly childhood vaccination clinics and its rates of immunisation for children was above average for the South Warwickshire Clinical Commissioning Group (CCG). Weekly antenatal and baby and children’s clinics were held and the practice demonstrated it had a close working relationship with the local midwives and health visitor teams. In addition, a GP gave regular post-natal talks at a local children’s centre. The practice provided cervical screening and a family planning service.

Updated 29 October 2015

This practice is rated as good for the care of older patients. Patients over the age of 75 had a named GP and were included on the practice’s avoiding unplanned admissions list to alert the team to patients who may be more vulnerable. Care plans were also in place for the most vulnerable patients, including those within the local care homes served by the practice. GPs also carried out regular ‘rounds’ and medicines reviews within each nursing home. GPs and practice nurses carried out visits to patients’ homes if they were unable to travel to the practice for appointments and one of the practice nurses specialised in home visits for older patients. Some of these visits were carried out jointly with the district nursing team when appropriate. For patients who lived over one mile away from the practice, the dispensary was able to deliver medicines to their home. The practice was involved with an over 75’s project in conjunction with Age UK, for the practice or organisation (depending on the patient need) to visit the homes of the most vulnerable elderly people in order to provide additional support where possible.

Updated 29 October 2015

This practice is rated as good for the care of working age patients, recently retired people and students. The practice provided extended opening hours until 9pm on Mondays and telephone consultations for patients unable to visit the practice during the day. NHS health checks were carried out for patients aged 40-75. The practice provided patients who smoked with smoking cessation support.

Updated 29 October 2015

This practice is rated as good for the care of patients experiencing poor mental health (including people with dementia). The practice had a register of patients at the practice with mental health support and care needs and invited them for annual health checks. Care plans were in place for these patients. Staff described close working relationships with the community mental health team, community psychiatric nurse and social services staff. These teams worked with the practice to identify patients’ needs and to provide patients with counselling, support and information. The practice carried out dementia screening.

Updated 29 October 2015

This practice is rated as good for the care of patients living in vulnerable circumstances. Patients had a named GP and regular reviews were carried out in conjunction with community nurses and matrons. One of the GPs was the lead for learning disability (LD) care at the practice and the practice had an LD register. All patients with learning disabilities were invited to attend for an annual health check. Staff were aware of safeguarding procedures and GPs told us how alerts were placed on the records of potentially vulnerable patients. The practice had a close working relationship with social services. When patients living in vulnerable circumstances required routine medical appointments, the practice tried to allocate appointments to a regular GP on each occasion. The practice allowed travellers to register as patients, however at the time of our inspection there were none on the patient list.