Archived: Dr R Hazeldine & Dr M Taylor

Updated 19 November 2015

Dr R Hazeldine & Dr M Taylor is a GP practice which provides a range of primary medical services to around 5,700 patients from a main surgery Westcotes Health Centre and a branch surgery in Colwell Medical Centre. The service is provided by two GP partners, three practice nurses (two of which are able to prescribe) alongside a practice manager and six reception/administration staff. Local community health teams support the GPs in provision of maternity and health visitor services.

The practice has two locations registered with the Care Quality Commission (CQC). We were not able to inspect the branch surgery as part of this inspection as it was registered incorrectly with the Care Quality Commission (CQC) as a separate location and therefore required a separate inspection. Since the inspection the practice have commenced the process to amend their registration. The location we inspected was Westcotes Health Centre, Fosse Road South, Leicester, Leicestershire, LE3 0LP.

The practice provides GP services under a General Medical Services (GMS) contract.

Both male and female life expectancy was in line with the national average. The age distribution of the practice has a higher percentage of people between the ages of 25 and 34 compared to the national profile.

The surgery is open from 8.30 am until 6.00 pm Monday to Friday. Appointments are available from 8.35 to 10.15am and 3.30 pm until 5.20 pm on these days other than Thursday when the surgery closes at 12.00pm.

The practice lies within the NHS Leicester City Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice was last inspected by the Care Quality Commission in July 2014, when it was judged to be in breach of Regulation 9 and 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 relating to:

• Care and welfare of people who use services

The practice did not have oxygen in place for dealing with emergencies which are reasonably expected to arise from time to time.

• Records

Safety alerts, Legionella testing certificates, patient safety alerts and staff appraisals were not always retained to provide a clear audit trail including, where appropriate, the outcomes and actions taken. Discussions, between healthcare professionals, were not always documented. The key to the medical records filing cabinets was not securely stored.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr R Hazeldine & Dr M Taylor practice on 29 July 2015.

Overall the practice is rated as good.

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

• Urgent appointments were available the same day.
• The practice had good facilities including disabled access and was found to be clean and tidy.
• Information about services and how to complain was available for patients.
• Patients were happy with the care provided and found all the staff to be caring and supportive.
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles.
• Recruitment checks were carried out and the appropriate recruitment checks had been undertaken prior to employment.
• The practice had a comprehensive business continuity plan in place for major incidents such as power failure or building damage.
• Patients who may be in need of extra support were identified by the practice.

However there were areas where the provider should make improvements.

Importantly the provider should:

• Ensure a patient participation group (PPG) is in operation.
• Ensure chaperone information is displayed in line with the practice’s chaperone policy.
• Ensure that all risk assessments relating to the building are stored in the building and accessible to staff

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

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. 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 medication needs were being met. Patients were encouraged to manage their conditions and were referred to health education and other in-house services such as a community matron. Special notes were used on the patient record enabling out of hours providers to be informed of any special information they may need in relation to these patients outside normal surgery hours.

Updated 19 November 2015

The practice is rated as good for the care of families, children and young people. There was a weekly health visitor clinic for parents to attend with their children and the health visitor was able to speak to GPs if necessary on the day of the appointment. The practice did not meet formally with a health visitor on a weekly basis to discuss safeguarding issues as this was done informally when the health visitor was holding their clinic. Communication also took place through the clinical system with GPs, nurses and health visitors. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 19 November 2015

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 and offered home visits if necessary, as well as same day appointments if needed. Every patient had a named GP. All patients over the age of 75 had been written to advising them of their named GP. The practice nursing team visited all housebound patients annually to perform a health check and encourage and give flu vaccinations. Residential care homes had been given a dedicated mobile phone number with which to contact the surgery to avoid going through the main reception telephone line, this call went to one of the GPs.

Updated 19 November 2015

The practice is rated good for the care of working-age people (including those recently retired and students). Whilst the practice surgery did not offer extended hours opening the appointment system meant that patients were always able to get an appointment on the same day. The practice had looked at the data for out of hours usage and both this and the patient satisfaction data supported this. The practice also offered telephone consultations with a clinician if requested and also offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 19 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 93% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health and they were supported by a mental health therapist who held a weekly clinic at the practice.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 19 November 2015

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 those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. Staff had been trained 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.