Archived: Blessing Medical Centre

Updated 22 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Blessing Medical Centre on the 11 March 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 30 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 Blessing Medical Centre 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 have received adult safeguarding training.

• All staff that act as chaperones had received chaperone training.

• 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).

• Patient Group Directions had been adopted by the practice and all were signed by the GP.

• The practice nurse had attended Mental Capacity Act and Gillick competency training.

• The nurse carried out weekly checks to the automated external defibrillator and these were all documented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 August 2015

The practice had a high prevalence of diabetes (5%). The Intelligence Monitoring Report showed that in 2013/14, the percentage of diabetic patients whose HBA1C was stable was 62%. As of the 1st of March 2015, it had become 75%. The GP told us this was achieved by improving recalling patients to attend for blood tests as well as additional training in Diabetes for staff. They also actively sought support from the local diabetic specialist community service which was set up in Brent in 2014. The practice now runs joint diabetic clinics with a specialist diabetic nurse or consultant from the service in attendance. Patients with poorly controlled diabetes were invited to this clinic in order to optimise their diabetic control. In addition, the practice nurse regularly undertakes reviews for Asthma, chronic obstructive pulmonary disease (COPD) and hypertension

Updated 20 August 2015

The practice ran a weekly mother and baby and baby immunisation clinics which provided an opportunity for mothers to express any concerns to the GP or nurse. Staff felt these clinics also provided the opportunity for mothers to meet other mothers with young families for peer support. The practice offered appointments on the day for all children under 5’s when their parent requests the child to be seen for urgent medical matters. The GPs demonstrated an understanding of Gillick competency and told us they actively promote sexual health advice and provides screening for chlamydia to young people and provide free condoms to patients on request. However, the nurse was not aware of Gillick competency.

All members of staff undertake safeguarding children training to ensure that they are up to date with current protocols. The practice had set up a ‘child protection’ register as well as a ‘child at risk’ register. These registers were discussed regularly at clinical meetings. The practice also liaised with the local health visitor when they have any concerns about particular children.

The practice offered a full range of immunisations for children, travel vaccines and flu vaccinations in line with current national guidance. Last year’s performance for child immunisations at age 12 months was approximately 70% which was similar to other practices in the CCG area.

Appointments were available outside of school hours and the premises were suitable for children and babies. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health. Clinicians offered family planning advice, fitted IUDs and prescribed the contraceptive pill.

Updated 20 August 2015

All patients over 75 years had a named GP to co-ordinate their care. The practice kept a register of elderly patients whose care needed to be prioritised and they made up approximately 2% of the practice population and all had care plans which were completed with the GP’s during face to face consultations. We saw carers were often involved in drafting the care plans. The GP told us they would encourage these patients to keep as active as possible and often refer them to local support groups. Older patients have been given a different telephone number to contact then practice to make it easier for them to get through to the practice. There were also alerts written in patient’s notes to ensure that the reception team offer these patients appointments with a GP or nurse on the same day.

Updated 20 August 2015

The practice offered an extensive range of health promotion and invited patients over 40 years of age to have an NHS health check. The practice offers working aged patients access to extended appointments on a Wednesday to 8pm. Patients could also make on-line appointments, order prescriptions and to get test results. They also offered phone consultations with the GP or the nurse for patients who could not attend the surgery.

Updated 20 August 2015

Patients with diagnoses mental health illness at the surgery was (2.8%). The practice had CBT therapists and counsellors based there three times a week to support patients experiencing poor mental health and supports patient with conditions such as depression and anxiety.

QOF data showed the practice had scored 100% for conditions commonly found amongst older people such as dementia and 71% for mental health.

Updated 20 August 2015

The practice has a vulnerable adult register to record patients who are vulnerable. Examples of such individuals are those who have learning disabilities, severe mental health illnesses or a history of domestic violence. These patients are discussed at clinical meetings to ensure that their needs are identified. Staff had a list of vulnerable patients to ensure they were prioritised for appointments. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.

Practice staff had access to an interpreter and translation service via language line to ensure that those patients whose first language was not English could access the service. The practice was accessible to disabled patients.