Archived: Matlock Road Surgery

Updated 7 January 2016

Matlock Road Surgery offers general medical services to approximately 3,000 registered patients within a residential area of Brighton and Hove. The practice had recently worked closely with other local practices in order to accommodate additional patients following the closure of a nearby practice. As a result, the practice list size had been capped at the time of our inspection in order to ensure the practice was able to manage and identify a maximum number of registered patients.

The practice delivers services to a higher number of patients under the age of 18 years when compared with the national average. The practice provides services to patients over the age of 65 years and patients over the age of 85 years, in numbers which mirror the national averages for those age groups. Care is provided to patients living in nearby residential facilities and a local hospice. Data available to the Care Quality Commission (CQC) shows the number of registered patients suffering income deprivation is below the national average.

Care and treatment is delivered by two GP partners. One of the GPs is female and one is male. The practice employs one practice nurse and utilises the services of one locum practice nurse. GPs and nurses are supported by the practice manager, an assistant practice manager and a team of reception and administration staff.

The practice was subject to a previous inspection on 30 May 2014. At this inspection we found that the practice was not meeting some of the legal requirements and regulations associated with the Health and Social Care Act 2008. We found that appropriate recruitment checks on staff had not been undertaken prior to their employment and that the practice had not ensured the safe storage of sharps bins. Following our inspection on 30 May 2014, the practice sent us an action plan detailing what they would do to meet the regulations. The practice did not receive a rating for its services following this inspection.

The practice is a GP training practice and supports undergraduates and new registrar doctors in training.

The practice is open between 8.30am and 6.00pm Monday to Friday. Extended hours appointments are offered on alternate Tuesday and Wednesday evenings until 7.30pm.

Services are provided from:

10 Matlock Road, Brighton, East Sussex, BN1 5BF.

The practice has opted out of providing out of hours services to its own patients and uses the services of a local out of hours service, IC24.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Matlock Road Surgery on 20 October 2015. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. 
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. 
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. There was a strong focus upon providing a caring service at all levels within the practice.
• Although risks to patients who used services were assessed, some systems and processes to address risks were not implemented well enough to ensure patients and staff were kept safe. For example in relation to emergency equipment, monitoring of medicines fridge temperatures and the clinical environment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. 
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• Information about services and how to complain was available and easy to understand.

The areas where the provider must make improvements are:

• Implement policies and procedures to ensure medicines are safely stored and monitored.
• Ensure sharps bins are sited safely in order to minimise the risks to staff, patients and visitors to the practice.
• Ensure there are clear and formal arrangements in place for the management of medical emergencies and for the assessment, monitoring and minimising of associated risks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff held a key role 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 medicine 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 7 January 2016

The practice is rated as good for the care of families, children and young people. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. 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 good for all standard childhood immunisations. A flexible appointment system was offered to promote access to 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 had a comprehensive screening programme. The practice’s uptake for the cervical screening programme was 81.21%, which was comparable to the national average of 81.89%.

Updated 7 January 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 worked closely with community teams to offer proactive, personalised care to meet the needs of the older people in its population. Older patients with complex care needs, for example, dementia and end of life care and those at risk of hospital admission, all had personalised care plans that were shared with local organisations to facilitate the continuity of care. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 7 January 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. Daily telephone consultations and extended hours appointments on one evening each week ensured that working age people could access the care they needed. 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.

Updated 7 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had identified a lead GP to coordinate the care of patients with serious mental illness. They worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The practice provided patients with support to access various support groups and additional services. They worked closely with a specialist psychiatric nurse to provide support to patients within the practice. Patients experiencing depression and anxiety were encouraged by the practice to access support from a local community mental health rapid response service. Advanced care planning was carried out for patients with dementia. There were systems 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 people with mental health needs and dementia.

Updated 7 January 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 and those with a learning disability. It offered longer appointments and carried out annual health checks for patients with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice ensured timely referral to urgent response services to ensure the changing needs of vulnerable patients were met. These included a community rapid response team and a roving GP service. Vulnerable patients were also provided with information 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.