The Old School Surgery

Updated 16 February 2017

The Old School Surgery is located in Stoney Stanton Leicestershire and cover Sapcote, Sharnford, Thurlaston and Elmesthorpe.

It provides primary medical services to 6,995 patients under a General Medical Services contract commissioned by West Leicestershire Clinical Commissioning Group. The practice list was steadily increasing by approximately 20 patients a week. The rise was expected to continue with existing and planned housing developments in the immediate area.

It is a member of the Hinckley and Bosworth Medical Alliance, a federation of 13 practices in the locality with over 121,000 patients.

Treatment and care is provided by four partner GPs ( two full time and two part time) and one Salaried GP. They are supported by two practice nurses, a healthcare assistant and a phlebotomist.

An anti-coagulant clinic is conducted at a branch surgery situated at Greencroft Annex, Off Carey Hill Road, Stoney Stanton Leicestershire LE9 4TY.

The premises at Stoney Stanton consist of four consulting rooms, two treatment rooms, a dispensary and offices on the top floor of the practice.

It is a dispensing practice, providing the service to 1,104 eligible patients.

The practice is mainly rural/commuter based with a higher number of patients aged 55-79 than the national average. Life expectancy is similar to both CCG and national averages. The practice is located in an area of low deprivation.

When the surgery is closed out-of-hours GP services are provided by Derbyshire Health United which was accessed by telephoning the NHS111 service.

Updated 16 February 2017

Letter from the Chief Inspector of General Practice

We had previously carried out an announced comprehensive inspection at The Old School Surgery on 29 September 2016 and found breaches of regulation and rated the practice as ‘Requires improvement’ in the safe key question. However the practice was rated as good overall. The full comprehensive report on the 29 September inspection can be found by selecting the ‘all reports’ link for The Old School Surgery on our website at www.cqc.org.uk.

Specifically we found that;

• The Greencroft annex branch surgery did not have an effective fire risk assessment in place.

• Self-employed and casual workers had not been subject to the appropriate scrutiny to ensure their suitability for working at the practice.

• The arrangements in place for responding to a medical emergency at the branch surgery required review.

• Consultation room doors were not always closed to maintain privacy and confidentiality.

• The clinical waste bin was not adequately secured.

This inspection was an announced focused inspection carried out on 12 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 29 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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Overall the practice is now rated as ‘Good’ in the safe key question and ‘Good’ overall.

Our key findings were as follows:

• A fire risk assessment for the Greentcroft annex had been completed by an external company and improvements in line with the report’s recommendations made.

• The practice had put measures in place to ensure the appropriate scrutiny of part time staff and self-employed workers.

• The procedures for dealing with a medical emergency had been reviewed.

• All staff had been reminded of the need to ensure privacy and confidentiality when treating patients.

• The clinical waste bin at the Greencroft annex branch surgery was suitably secured.

• Staff working at the Greencroft annex branch surgery had been issued with personal alarms to give them re-assurance and support when working in this location.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 November 2016

The practice is rated as good for the care of people with long-term conditions.

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Patients with diabetes had their condition monitored and managed. For example the percentage of patients with diabetes, on the register, who had an influenza immunisation in the preceding 1 August to 31 March was 100% compare to a CCG average of 96% and national average of 94%. Other indicators in respect of this condition were similarly higher than both CCG and national averages.

• Longer appointments and home visits were available when needed.

• 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

Updated 28 November 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, for example, children and young people who had a high number of A&E attendances. 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.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test has been performed in the preceding 5 years was 85% which was comparable to the CCG average of 83% and the national average of 82%.

• Appointments were available outside of school hours.

• The premises were suitable for children and babies. We saw positive examples of joint working with midwives, district nurses and health visitors.

Updated 28 November 2016

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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Individual GPs were assigned responsibility for patients residing in care and nursing homes to promote continuity of care.

• GPs conducted weekly ‘ward rounds ‘ at nursing and care homes, in addition to ad hoc visits as required.

• Nursing and care homes were provided with a dedicated number to avoid them needing to go through the practice reception procedure.

• Patients who had been identified as being at a high risk of hospital admission were able to access GP treatment and care at the weekend as the practice was a member of the Hinckley and Bosworth Medical Alliance Federation weekend access scheme.

Updated 28 November 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.

• Face to face and telephone consultations were available from 7.30am to 6.30pm and 3.30pm to 7.15pm on two days a week.

• The range of online services provided by the practice sought to alleviate access problems commonly experienced by patients in this population group.

Updated 28 November 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 28 November 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 those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients 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.