Background to this inspection
Updated
15 July 2016
Commonfield Road Surgery is situated in a deprived area of Wirral and is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post-natal care.
The practice has a General Medical Services (GMS) contract with a registered list size of 5299 patients (at the time of inspection). The practice has two male GP partners, two non-medical partners, two female salaried GPs, an advanced nurse practitioner, two practice nurses, a healthcare assistant, a practice manager and a number of administration and reception staff. The practice is a training practice for medical students.
The practice is open 8.30am to 6pm Monday to Friday and provides extended hours Monday 6pm to 7.30pm. Appointments are bookable in person, on line or by telephone. Home visits and telephone consultations are available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients received urgent medical assistance when the practice was closed. Out of hours patients are asked to contact the NHS 111 service to obtain healthcare advice or treatment.
Updated
15 July 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Commonfield Road Surgery - Brodbin C on 17 May 2016. 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.
- Risks to patients were assessed and well managed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.
- Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients said they found it easy to make an appointment and there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- 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.
- The provider was aware of and complied with the requirements of the duty of candour.
The areas where the provider should make improvement are:
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Audits carried out should have a second cycle to monitor that changes made were embedded.
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The system used to monitor children and young people’s attendance at A&E and non-attendance at secondary care services should be reviewed to ensure all relevant information is recorded and when necessary acted upon.
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A system should be put in place to enable an annual review of incidents to take place to identify possible trends.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
15 July 2016
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Longer appointments and home visits were available when needed.
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All these patients had a named GP and a structured annual review to check their health and medicines 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.
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The practice had adapted review and assessment computerised templates to ensure standardised management for patients with long-term conditions.
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The practice provided a range of services such as phlebotomy, diabetic foot checks and INR testing (a blood test that checks how long it takes for blood to clot) to support patients to effectively manage their long term conditions).
Families, children and young people
Updated
15 July 2016
The practice is rated as good for the care of families, children and young people.
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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.
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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.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
- We saw positive examples of joint working with midwives, health visitors and school nurses.
Updated
15 July 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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The practice provided a named and accountable GP for patients 75 years and over.
Working age people (including those recently retired and students)
Updated
15 July 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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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.
People experiencing poor mental health (including people with dementia)
Updated
15 July 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
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Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
15 July 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including patients with a learning disability.
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The practice offered longer appointments for patients with a learning disability.
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The practice regularly worked with other health care professionals in the case management of vulnerable patients.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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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.