Archived: Brook Green Surgery

Updated 12 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Brook Green Surgery on the 3 December 2015. The practice was rated as requires improvement for providing safe care. After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to ensure the care they provided was effective and met the standard required by CQC.

We undertook this focussed inspection on 25 July 2016 to check that the practice had followed their plan and to confirm that they were now providing safe care. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Brook Green Surgery on our website at www.cqc.org.uk.

Overall the practice was rated as Good.

Following the focussed inspection we found the practice to be good for providing safe care.

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

• All staff had been Disclosure and Barring Service checked. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

• All patient records were kept in safe and secured locked cabinets.

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. Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

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 and follow up children living in disadvantaged circumstances and who were at risk. 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. Appointments were available outside of school hours and the premises were suitable for children and babies, although it was difficult to access the surgery with a pushchair due to the steps leading to the entrance. However, there is a ramp that staff put out for pushchair access when needed. We saw good examples of joint working with health visitors.

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 offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in end of life care. It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. There was a register for older people who have complex needs, required additional support or were housebound and care plans were in place to ensure these patients and their families received coordinated care and support.

Updated 18 February 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. The practice offered early morning appointments with the GP every Thursday 7am to 8am.

Updated 18 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). One-hundred percent of patients diagnosed with dementia had had their care reviewed in a face-to-face meeting in the last 12 months (01/04/2014 to 31/03/2015). They worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. However, they had identified the need to worker closer in collaboration with the mental health care worker in liaising with patients with identified risk who were not compliant with their medication. The practice had screened 50 patients on the dementia-screening programme in the last 7 months, increasing their diagnosis screening to 0.4% (compared to 0.6% national average). They had identified the need to have a trained member of staff in the practice to screen and mobilise referrals to memory clinics. Staff at the practice had signed up to become a dementia friend.

Updated 18 February 2016

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. It offered longer appointments for people with a learning disability. Staff knew how to recognise signs of abuse in vulnerable adults and children. The 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. However, the practice was not proactively reaching out to hard to reach patients, and the practice understood that they needed to be more proactive in signposting vulnerable patients about how to access various support groups and voluntary organisations.